Endocrine mucin-producing sweat gland carcinoma of the cheek.

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a low-grade adnexal malignant neoplasm. We report a 90-year-old man who had a hard, dome-shaped tumor approximately 9 mm in diameter on the left cheek. Dermoscopy showed an overall, non-uniformly light-pink tumor with crust. The diagnosis of EMPSGC is made histologically from excisional biopsy. No signs of recurrent disease were evident at 42 months postoperatively.

Invasive urothelial carcinoma with chordoid features may be an ominous sign predicting sarcomatoid change: a case report of a bladder carcinoma.

Invasive urothelial carcinoma with chordoid features has not been reported since being first documented in 2009. Here we report a further case of it, involving an 85-year-old man with a papillary tumor of the urinary bladder, measuring 3 cm in diameter. This case is unique in that an epithelial-mesenchymal transition was suspected to have occurred in the transformation of a conventional urothelial carcinoma to a sarcomatoid variant, with invasive urothelial carcinoma with chordoid features acting as an intermediate stage. Based on this finding, we recommend that the presence of invasive urothelial carcinoma with chordoid features should be reported as it may predict the coexistence or future development of an aggressive sarcomatoid variant.

Gray-edged line sign of scabies burrow.

A scabies burrow is created by a mature female mite laying eggs through the stratum corneum, representing a kind of scabies eruption. We have noticed that the edges of the scabies burrow sometime appear as blackish-gray lines. We named these lines the "gray-edged line" sign, as a new feature of scabies burrows. The gray-edged line sign has the following two tendencies: (i) it is rarely seen on the palm or sole; and (ii) when the burrow follows a curved course, the gray-edged line often forms on the outer wall. Explaining the formation of this sign from clinical findings was difficult, so the aim of the present study was to elucidate the mechanisms underlying the gray-edged line sign. This retrospective study involved collection of data from electronic medical records of patients treated for scabies in our department between April 2015 and February 2020. We treated 32 scabies patients, including 4 patients with the gray-edged line sign. We analyzed clinical features, dermoscopy, histopathology and special stains. Fontana-Masson staining showed melanin staining in three parts: feces; some keratinocytes around the scabies burrows; and the mouth and legs of the scabies mite. The gray-edged line sign appears to represent mite feces containing melanin.