Angiokeratoma circumscriptum.

Angiokeratoma circumscriptum is the rarest variant of angiokeratoma. It usually affects females and it is characterized by dark-red to blue-black confluent papules or nodules on lower limbs in a segmental and unilateral distribution. We describe the clinical and histopathological findings in a patient with angiokeratoma circumscriptum and discuss the etiology, associations, diagnosis, differential diagnosis, and treatment.

Differential Clinicopathological Features in Spontaneous Regression of Melanomas and Melanocytic Naevi.

The aim of this study was to determine the clinical, histological and/or immunohistochemical features that enable differential diagnosis of regression of melanocytic naevi from regression of melanomas. All melanocytic neoplasms with histologically-confirmed regression diagnosed in our hospital between 2002 and 2009 were reviewed retrospectively. Lamellar and delicate fibrosis were associated with melanocytic naevi (p <0.0001 and p = 0.021, respectively). Compact fibrosis, high vessel density and higher number of granzyme B+ lymphocytes were associated with malignant melanoma (p = 0.011, p = 0.005 and p = 0.013, respectively). Density of inflammatory infiltrate (p = 0.016), vascular proliferation (p = 0.005), epidermal atrophy (p = 0.009), rate of apoptosis (p = 0.046) and granzyme B immunoreactivity (p = 0.013) was more common in severe-dysplastic naevi and melanomas than in the remaining melanocytic naevi. Logistic regression demonstrates that 5 variables (age, lamellar fibrosis, melanophages, vessel density, and granzyme B immunostaining) would serve to classify appropriately 87% of melanomas among melanocytic lesions with complete regression.

Spontaneous regression of multiple melanocytic nevi after melanoma: report of 3 cases.

Complete spontaneous regression of multiple melanocytic nevi after melanoma is an extremely rare phenomenon. We report 3 cases of patients with a history of melanoma that showed regression of almost all melanocytic nevi over time. One of the patients had 2 simultaneous primary cutaneous melanomas without metastasis. In the other 2 patients, regression of the melanocytic nevi was seen after the development of metastasis in lymph nodes. These patients had spontaneously developed an efficient immune response against melanocytes, and they would represent paradigmatic examples of the spontaneous immune responses in melanoma patients. Better understanding of the mechanisms involved in the complete regression of melanocytic lesions would lead to a better selection of melanoma patients for immunotherapy.

Eccrine angiomatous hamartoma in a child.

Eccrine angiomatous hamartoma (EAH) is a rare, benign malformation characterized by both eccrine and vascular components. It usually presents at birth or during early infancy and childhood as a nodule or a plaque, usually solitary, involving acral skin. Eccrine angiomatous hamartoma is usually asymptomatic, although focal hyperhidrosis, hypertrichosis, and pain can be observed. We report an additional case of this rare entity presenting in a 14-year-old boy.

Psoriasis of the lips.

BACKGROUND: Psoriasis is a frequently occurring disorder with a chronic and relapsing course. Common sites of involvement are the extremities, trunk, scalp and nails. The disease may occasionally involve genitalia and the anus. Although cutaneous lesions are generally sufficiently distinct to make a diagnosis, diagnostic difficulties can be found in cases of unusual involvement. MAIN OBSERVATIONS: We report a 38-year-old man who presented scaling and cracking of the lips without intraoral involvement as a first manifestation of psoriasis. Three years later he developed erythematous plaques with desquamation on fingers, characteristic of psoriasis. CONCLUSION: Psoriasis should be considered in the differential diagnosis of chronic or recurrent labial lesions.

Granular parakeratosis.

A healthy 62-year-old woman was referred to our dermatology department with a 1-month history of a pruritic axillary eruption. On examination, multiple erythematous and brownish hyperkeratotic papules were seen in both axillae. Some of these lesions coalesced into plaques, with small areas of sparing, and a background erythematous color was also found in the axillary vaults (Fig. 1). There was no involvement of other intertriginous sites and there were no associated systemic symptoms. The patient was not obese. The patient had removed the hair from her axillae with wax 3 weeks before the development of the eruption. Moreover, she had changed her antiperspirant 1 week before the onset of the lesions. A cutaneous biopsy for histologic analysis was performed. Histologically, the stratum corneum was thickened, with persistent nuclei together with countless small basophilic granules. The granular layer was preserved and, in some areas, hypergranulosis was found (Fig. 2). These findings were characteristic of granular parakeratosis. The cutaneous lesions resolved completely after 1 week of treatment with topical betamethasone dipropionate and gentamicin sulfate (twice daily). The patient was urged to discontinue her use of deodorants.

Familial generalized multiple glomangiomyoma: report of a new family, with immunohistochemical and ultrastructural studies and review of the literature.

Glomus tumors are benign lesions which often appear as solitary bluish nodules. They can also be multiple, and can be either acquired or congenital. Histopathologically glomus tumors are classified into three different variants: solid glomus tumor, glomangioma, and glomangiomyoma, which is the least frequent type. We report three instances of familial generalized multiple glomangiomyoma in a woman and her two children. Seven members of the family in two consecutive generations were affected, suggesting autosomal dominant inheritance. We performed a thorough clinical study, complete blood and platelet counts, stool for occult blood, karyotype, abdominal echography (which showed an asymptomatic solitary hepatic vascular lesion in one of the patients), gastrointestinal endoscopy, and skin biopsy with immunohistologic and ultrastructural studies. We believe that the terms glomangioma and glomangiomyoma actually designate the same lesion, with transitional areas from typical glomus cells to well-defined conventional smooth muscle cells. Although complete evaluation should be performed in all patients with multiple glomus tumors in order to detect possible occult systemic lesions, we only recommend treatment for symptomatic lesions. To our knowledge, this is the first report of an instance of familial multiple glomangiomyoma.