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1.
J Cutan Pathol ; 50(2): 113-117, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36059094

RESUMO

Glomus tumors are rare mesenchymal neoplasms composed of cells resembling the glomus body. They are most frequently seen in subungual regions but have been reported to arise in almost every anatomic location. Malignant glomus tumors, also called glomangiosarcomas, of cutaneous origin are exceedingly rare with only 47 reported cases. The genetic alterations that lead to the development of cutaneous malignant glomus tumors are not well understood. Small studies report glomus tumors with mutations in glomulin (GLMN), NF1, BRAF, NOTCH, PDGFRB, KRAS, and SMARCB1. These mutations have mostly been studied in deep or visceral glomus tumors. We report a case of a cutaneous malignant glomus tumor with a CCND3 point mutation identified on next generation sequencing, without any of the previously described genetic mutations. CCND3 mutations that cause cyclin D3 amplification may prove to be targets for CDK4/6 inhibitors in the treatment of malignant glomus tumors.


Assuntos
Tumor Glômico , Sarcoma , Humanos , Tumor Glômico/genética , Tumor Glômico/patologia , Sarcoma/patologia , Pele/patologia , Mutação , Ciclina D3/genética
2.
Am J Dermatopathol ; 45(12): 843-846, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37883932

RESUMO

ABSTRACT: Leprosy is a disease caused by Mycobacterium leprae that, depending on a patient's baseline susceptibility and immune system function, can present in a wide variety of ways. The host's immune system response to the infection can be cell-mediated or humoral and can be further altered by changes in immune function or treatment. Depending on the time at which a skin biopsy is taken from affected areas, different inflammatory cell types are present, and the histopathology can mimic that of other infectious, autoimmune, or malignant entities, especially when the clinical information provided is vague. We present a case of a 24-year-old Micronesian woman who initially presented immediately postpartum with clinical and histopathological findings suggestive of urticarial vasculitis, but a subsequent biopsy resulted in a diagnosis of erythema nodosum leprosum reaction and borderline multibacillary leprosy. This case illustrates an unusual clinical and histological presentation of M. leprae and highlights the importance of clinical history.


Assuntos
Hanseníase Dimorfa , Hanseníase , Urticária , Vasculite , Feminino , Humanos , Adulto Jovem , Adulto , Mycobacterium leprae , Hanseníase Dimorfa/diagnóstico , Hanseníase Dimorfa/tratamento farmacológico
3.
Opt Express ; 30(9): 14686-14708, 2022 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-35473208

RESUMO

Illuminant-induced metameric mismatch is an important consideration in the specification of light sources for some architectural environments, yet there is currently no standardized performance measure. The goal of this work was to evaluate two recent research proposals: the metameric uncertainty index (Rt) and the metamer mismatching color rendering index (MMCRI). To compare the relative performance of these two measures, 100,000 spectral power distributions were generated with 3, 4, 5, 6, and 7 Gaussian spectral components and spectral widths varying from 1 nm (monochromatic) to 100 nm. Both measures generally agree with the theory that broadband radiation should cause less metameric mismatch than narrowband radiation. The two measures have relatively better agreement for broadband SPDs and relatively worse agreement for narrower spectra. Despite some similarities, non-parametric statistical tests suggest that Rt and MMCRI are significantly different quantifications of illuminant-induced metameric mismatch (p < 0.0001 for all comparisons). Characteristics of the MMCRI computation that are potentially problematic for applied lighting were observed.

4.
J Cutan Pathol ; 49(6): 570-574, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35020219

RESUMO

Dystrophic calcification is a common histopathologic finding that can be concomitant with a plethora of diseases, ranging from self-limited infections to insidious malignancies. Gamna-Gandy bodies (GGBs) are a form of dystrophic calcification associated with chronic hemolysis and are typically observed in the spleen. In this report, we present the case of a 92-year-old man who presented with a 4-mm blue papule that was biopsied given the concern for a blue nevus. The subsequent histopathologic examination of the biopsy specimen showed a dermal organizing hematoma adjacent to pale-yellow to brown, refractile material within fibrotic collagen consistent with GGBs. Scanning electron microscopy with energy-dispersive x-ray analysis (SEM/EDXA) revealed that the structures were composed of carbon (39%), oxygen (32%), iron (16%), phosphorus (7%), calcium (5%), and sodium (1%). Fourier transform infrared spectroscopy identified amorphous calcium phosphate. GGBs have not been previously described in the skin and have been rarely characterized with SEM/EDXA in other sites.


Assuntos
Calcinose , Baço , Idoso de 80 Anos ou mais , Calcinose/patologia , Cálcio , Humanos , Masculino , Baço/patologia
5.
Public Health Nutr ; 24(17): 5577-5588, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34369345

RESUMO

OBJECTIVE: To examine differences in the availability, variety and distribution of foods and beverages sold at street food stands (SFS) across neighbourhood income levels in Mexico City. DESIGN: Cross-sectional. SETTING: Twenty neighbourhoods representing low-, middle- and high-income levels in Mexico City. PARTICIPANTS: Direct observations of SFS (n 391). RESULTS: The availability of healthy foods such as fruits/vegetables was high in middle- and high-income neighbourhoods, whereas the availability of unhealthy foods such as processed snacks was higher in low-income neighbourhoods. However, statistically significant differences in food availability across neighbourhoods were only observed for dairy and processed snack items (P < 0·05). Similarly, differences in variety were only observed for cereal and processed snacks (P < 0·05). No statistically significant differences were seen for variety of fruits/vegetable across neighbourhood income levels (P > 0·05). No statistically significant differences across neighbourhood income levels were observed for beverage availability and variety (P > 0·05). Although street foods and beverages were often distributed near homes, public transportation centres and worksites, no differences were observed across neighbourhood income levels (P > 0·05). CONCLUSIONS: Findings suggest that SFS can be a source of both unhealthy foods and healthy foods for communities across neighbourhoods in Mexico City. Additional studies are needed to assess the relationship between street food and beverage availability, and consumption.


Assuntos
Bebidas , Comércio , Estudos Transversais , Abastecimento de Alimentos , Humanos , México , Lanches , Verduras
6.
Am J Dermatopathol ; 42(8): 608-611, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32701697

RESUMO

Melanoma with cartilaginous differentiation is a rare histologic subtype that has been reported in the literature. It often presents clinically different than conventional melanomas and can be diagnostically challenging. Molecular alterations in previously reported cases have not been published. We present a case of melanoma with chondroid stroma from a 70-year-old man that was found to contain an NRAS mutation (c.182A>G (p.Q61R)) via Illumina TruSight Tumor 15 (TST15) next generation sequencing assay.


Assuntos
GTP Fosfo-Hidrolases/genética , Melanoma/genética , Melanoma/patologia , Proteínas de Membrana/genética , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Adenocarcinoma , Idoso , Carcinoma Basocelular , Humanos , Masculino , Mutação , Segunda Neoplasia Primária/genética , Segunda Neoplasia Primária/patologia , Neoplasias da Próstata
7.
Am J Dermatopathol ; 40(8): 597-601, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29406432

RESUMO

Pseudomyogenic hemangioendothelioma (PHE; epithelioid sarcoma-like hemangioendothelioma) is a rare entity, with 129 reported cases. It is a rarely metastasizing, low-grade vascular tumor that can histologically mimic epithelioid sarcoma and often presents as multiple discontinuous nodules in the extremities. PHEs characteristically and consistently show immunoreactivity for cytokeratins and endothelial markers. We present a case in the thigh of a 65-year-old-man with a 3-month history of painful lesions in the dermis and review the published literature. In our case, the lesion exhibited the characteristic histologic findings and immunoprofile of a PHE: a solid proliferation of spindled to epithelioid cells with abundant eosinophilic cytoplasm and frequent rhabdoid cells. Cytologic atypia and mitotic figures were inconspicuous. The tumor cells were immunoreactive for CD31, ERG, AE1/3, and CK7 and negative for D2-40, P53, HMB45, desmin, CD34, SMA, EMA, and S100 protein. A balanced reciprocal translation between chromosomes 7 and 19 was present; this translocation seems unique to PHE. PHE is a unique and commonly misdiagnosed entity; therefore, we review the literature to describe the characteristics of this tumor.


Assuntos
Hemangioendotelioma/patologia , Neoplasias de Tecidos Moles/patologia , Idoso , Biomarcadores Tumorais/análise , Humanos , Masculino , Coxa da Perna/patologia
8.
Am J Dermatopathol ; 39(1): e8-e12, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28045755

RESUMO

The congenital melanocytic nevus is a pigmented melanocytic lesion that presents at birth or shortly thereafter. It is commonly described on the skin, usually on the trunk and extremities. Only five intraoral cases of congenital melanocytic nevi have been described in the English literature. A nevus spilus (speckled lentiginous nevus) is a clinical variant of congenital melanocytic nevus. The authors present the case of a 19-year-old male with an intraoral nevus spilus. The anterior mandibular gingiva exhibited multiple speckled, pigmented papules and macules on a thickened, hyperplastic macular background. Microscopic examination revealed characteristic morphologic features of intramucosal nevi extending into the deep portions of the submucosa. Although other authors have reported similar clinical presentation in the oral mucosa, no other case reports were found in the English literature classifying an intraoral congenital nevus as an intraoral nevus spilus. The sixth case of an intraoral congenital melanocytic nevus and the first case subclassified as an intraoral nevus spilus (speckled lentiginous nevus) is reported, with a review of the literature.


Assuntos
Gengiva/patologia , Neoplasias Gengivais/patologia , Melanócitos/patologia , Nevo Pigmentado/patologia , Biópsia , Gengiva/cirurgia , Neoplasias Gengivais/congênito , Neoplasias Gengivais/cirurgia , Humanos , Masculino , Invasividade Neoplásica , Nevo Pigmentado/congênito , Nevo Pigmentado/cirurgia , Adulto Jovem
9.
Am J Dermatopathol ; 38(8): e122-4, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26913848

RESUMO

Spindle cell/pleomorphic lipoma is an uncommonly encountered benign neoplasm that is usually found in the subcutaneous tissues. Rare cases reported in the literature have an intradermal location. This lesion usually presents as a subcutaneous nodule on the neck, shoulders, or back of middle-aged to elderly males. Although spindle cell and pleomorphic lipoma are currently considered the same entity, they were historically categorized separately. The authors report a case of hyperpigmented papule with an associated subcutaneous nodule on the left cheek of a 56-year-old man, review the literature, and discuss several important diagnostic pitfalls of spindle cell/pleomorphic lipoma.


Assuntos
Hiperpigmentação/patologia , Lipoma/patologia , Neoplasias Cutâneas/patologia , Pigmentação da Pele , Biomarcadores Tumorais/análise , Biópsia , Bochecha , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Lipoma/química , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Neoplasias Cutâneas/química
10.
Am J Dermatopathol ; 38(4): e49-51, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26999346

RESUMO

Deep penetrating fibrous histiocytoma (DPFH) is a rare variant of fibrous histiocytoma that can arise in the subcutis and deep soft tissues with different clinical implications from dermatofibromas. Dermatofibromas are mainly cosmetic annoyances and do not require surgical management. However, the DPFH does require that negative surgical margins be achieved because of the possibility of local recurrence and distant metastasis. We describe a case of a 24-year-old man diagnosed with DPFH through histologic examination and immunohistochemistry. The lesion displayed diffuse, strong D2-40 positivity and a minority of cells were highlighted with factor XIIIa. The lesion was negative for CD34. The patient's lesion was incompletely excised and a repeat excision was required.


Assuntos
Histiocitoma Fibroso Benigno/patologia , Neoplasias de Tecidos Moles/patologia , Biomarcadores Tumorais/análise , Antebraço/patologia , Humanos , Imuno-Histoquímica , Masculino , Adulto Jovem
11.
Opt Express ; 23(12): 15888-906, 2015 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-26193567

RESUMO

We have developed a two-measure system for evaluating light sources' color rendition that builds upon conceptual progress of numerous researchers over the last two decades. The system quantifies the color fidelity and color gamut (change in object chroma) of a light source in comparison to a reference illuminant. The calculations are based on a newly developed set of reflectance data from real samples uniformly distributed in color space (thereby fairly representing all colors) and in wavelength space (thereby precluding artificial optimization of the color rendition scores by spectral engineering). The color fidelity score R(f) is an improved version of the CIE color rendering index. The color gamut score R(g) is an improved version of the Gamut Area Index. In combination, they provide two complementary assessments to guide the optimization of future light sources. This method summarizes the findings of the Color Metric Task Group of the Illuminating Engineering Society of North America (IES). It is adopted in the upcoming IES TM-30-2015, and is proposed for consideration with the International Commission on Illumination (CIE).

12.
Am J Dermatopathol ; 36(7): e121-4, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24247582

RESUMO

Granular cell basal cell carcinoma (BCC), characterized by large cells with abundant eosinophilic cytoplasm and conspicuous granularity, is an extremely rare variant of BCC with only 14 cases reported in the literature to date. A case of an 82-year-old man with clinically suspected BCC of the face is presented. Microscopic examination demonstrated characteristic morphologic and immunophenotypic features of granular cell BCC, as well as novel expression of p16 and lack of bcl-2 expression, both of which are previously undescribed in granular BCCs in the literature to date. Although very rare, this entity is important to include in the differential of any nodular cutaneous neoplasm with granular features. The rarity of this lesion makes immunohistochemistry especially helpful. As in other BCCs, granular cell BCCs typically strongly express Ber-EP4 and cytokeratins. The granular BCCs are characteristically periodic acid-Schiff positive, but show no expression of S100 protein. The rarity of the granular cell BCC and the aggressive biological behavior of the entities that may share similar histologic features make arriving at the correct diagnosis paramount to appropriate clinical management. The fifteenth case of granular cell BCC with subsequent review of the literature is reported, with particular focus on the immunohistochemical characteristics.


Assuntos
Carcinoma Basocelular/patologia , Corpos de Inclusão/patologia , Neoplasias Cutâneas/patologia , Idoso de 80 Anos ou mais , Humanos , Imuno-Histoquímica , Masculino
13.
Res Sq ; 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38766254

RESUMO

Background: Food insecurity, an ongoing and accelerating problem in the U.S., is an economic and social condition involving limited or uncertain access to adequate food. Some of the highest rates of food insecurity in 2022 were found among individuals who were Hispanic-Latinx (20.8%), a population that already faces disproportionate health and socioeconomic disadvantages. There remains an urgent health-related need to identify sustainable strategies to prevent food insecurity in the Latinx population. Methods: A first-generation pilot investigation was conducted using data derived from a sub-study connected to the Computerized Physical Activity Support for Seniors (COMPASS) Trial, a 12-month cluster-randomized controlled trial among older Latinx adults. The sub-study focused on two nutrition interventions that included 1) the Food Literacy and Nutrition (FLAN) curriculum, and 2) a nutrition information-only control. Research hypotheses aimed to determine whether the FLAN intervention reduced food insecurity and increased daily fruit and vegetable servings. Results: On average, participants (n = 39) were 61.5 years of age (SD = 6.7), mostly female (69%), and reported Spanish as their primary language (69%). The FLAN intervention was associated with decreased odds of food insecurity at 12 months (AOR = 0.71, 95% CI = 0.54, 0.95; p = 0.03) when compared to the nutrition-information only control intervention. Although no between-group differences in daily fruit and vegetable servings were found, there was a significant correlation between changes in daily fruit and vegetable servings from baseline to six months and changes in food insecurity from baseline to 12 months (r = -0.51, p = 0.01). Conclusions: The FLAN intervention, a bilingual and culturally tailored educational curriculum, yielded 12-month improvements in food security among a small sample of older Latinx adults. Evidence from this investigation suggests the potential utility of implementing the FLAN curriculum among individuals who are at an increased risk of food insecurity. Further investigation in a larger sample is merited to determine whether the 12-month decreases in food insecurity that were produced by the FLAN intervention can be replicated. Trial Registration: ClinicalTrials.gov Identifier: NCT02111213.

14.
BMC Nutr ; 10(1): 102, 2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39044224

RESUMO

BACKGROUND: Food insecurity, an ongoing and accelerating problem in the U.S., is an economic and social condition involving limited or uncertain access to adequate food. Some of the highest rates of food insecurity in 2022 were found among individuals who were Hispanic/Latinx (20.8%), a population that already faces disproportionate health and socioeconomic disadvantages. There remains an urgent health-related need to identify sustainable strategies to prevent food insecurity in the Latinx population. METHODS: A first-generation pilot investigation was conducted using data derived from a sub-study connected to the Computerized Physical Activity Support for Seniors (COMPASS) Trial, a 12-month cluster-randomized controlled trial among older Latinx adults. The sub-study focused on two nutrition interventions that included (1) the Food Literacy and Nutrition (FLAN) curriculum, and (2) a nutrition information-only control. Research hypotheses aimed to determine whether the FLAN intervention reduced food insecurity and increased daily fruit and vegetable servings. RESULTS: On average, participants (n = 39) were 61.5 years of age (SD = 6.7), mostly female (69%), and reported Spanish as their primary language (69%). The FLAN intervention was associated with decreased odds of food insecurity at 12 months (AOR = 0.71, 95% CI = 0.54, 0.95; p = 0.03) when compared to the nutrition-information only control intervention. Although no between-group differences in daily fruit and vegetable servings were found, there was a significant correlation between changes in daily fruit and vegetable servings from baseline to six months and changes in food insecurity from baseline to 12 months (r = -0.51, p = 0.01). CONCLUSIONS: The FLAN intervention, a bilingual and culturally tailored educational curriculum, yielded 12-month improvements in food security among a small sample of older Latinx adults. Evidence from this investigation highlights the potential utility of implementing the FLAN curriculum among individuals who are at an increased risk of food insecurity. Further investigation in a larger sample is merited to determine whether the 12-month decreases in food insecurity that were produced by the FLAN intervention can be replicated. TRIAL REGISTRATION: ClinicalTrials gov Identifier: NCT02111213. Registered on 04/02/2014.

15.
JAMA Dermatol ; 160(8): 838-845, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38759225

RESUMO

Importance: BRCA1-associated protein (BAP1) tumor predisposition syndrome (TPDS) is a cancer genodermatosis associated with high risk of uveal and cutaneous melanoma, basal cell carcinoma, and multiple internal malignant neoplasms, including mesothelioma and renal cell carcinoma. Early detection of the syndrome is important for cancer surveillance and genetic counseling of family members who are at risk. Objective: To determine the prevalence of nail abnormalities in individuals with pathogenic germline variants in BAP1. Design, Setting, and Participants: In this prospective cohort study, individuals who were known carriers of pathogenic BAP1 germline variants were consecutively enrolled between October 10, 2023, and March 15, 2024. Dermatologic evaluation for nail abnormalities was performed, including a history of nail abnormalities and associated symptoms, physical examination, medical photography, and nail biopsy for histopathology. This was a single-center study conducted at the National Institutes of Health Clinical Center. Main Outcomes and Measures: Primary outcomes were the prevalence and spectrum of nail changes and histopathologic characterization. Results: Among 47 participants (30 female [63.8%]; mean [SD] age, 46.4 [15.1] years) ranging in age from 13 to 72 years from 35 families, nail abnormalities were detected in 41 patients (87.2%) and included leukonychia, splinter hemorrhage, onychoschizia, and distal nail hyperkeratosis. Clinical findings consistent with onychopapilloma were detected in 39 patients (83.0%), including 35 of 40 individuals aged 30 years or older (87.5%). Nail bed biopsy was performed in 5 patients and was consistent with onychopapilloma. Polydactylous involvement with onychopapillomas was detected in nearly all patients who had nail involvement (38 of 39 patients [97.4%]). Conclusions and Relevance: This study found that BAP1 TPDS was associated with a high rate of nail abnormalities consistent with onychopapillomas in adult carriers of the disease. Findings suggest that this novel cutaneous sign may facilitate detection of the syndrome in family members who are at risk and patients with cancers associated with BAP1 given that multiple onychopapillomas are uncommon in the general population and may be a distinct clue to the presence of a pathogenic germline variant in the BAP1 gene.


Assuntos
Predisposição Genética para Doença , Mutação em Linhagem Germinativa , Neoplasias Cutâneas , Proteínas Supressoras de Tumor , Ubiquitina Tiolesterase , Humanos , Ubiquitina Tiolesterase/genética , Feminino , Proteínas Supressoras de Tumor/genética , Masculino , Pessoa de Meia-Idade , Adulto , Estudos Prospectivos , Idoso , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Adulto Jovem , Adolescente , Doenças da Unha/genética , Doenças da Unha/patologia , Doenças da Unha/epidemiologia , Doenças da Unha/diagnóstico , Prevalência , Papiloma/patologia , Papiloma/genética , Papiloma/epidemiologia , Papiloma/diagnóstico , Síndromes Neoplásicas Hereditárias/diagnóstico , Síndromes Neoplásicas Hereditárias/genética , Síndromes Neoplásicas Hereditárias/patologia , Unhas Malformadas/genética , Unhas Malformadas/epidemiologia , Unhas Malformadas/diagnóstico
16.
Clin Cancer Res ; : OF1-OF13, 2024 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-39287419

RESUMO

PURPOSE: Sebaceous carcinoma is the third most common nonkeratinocyte skin cancer in the United States with 1,000 cases per year. The clinicopathologic features of sebaceous carcinoma and benign sebaceous neoplasms (adenomas, sebaceomas) can overlap, highlighting the need for molecular biomarkers to improve classification. This study describes the genomic and transcriptomic landscape of sebaceous neoplasms in order to understand tumor etiology and biomarkers relevant for diagnosis and treatment. EXPERIMENTAL DESIGN: We performed whole-genome sequencing (WGS) and whole-transcriptome sequencing (WTS) of sebaceous neoplasms from six academic and two federal healthcare facilities in the United States diagnosed between January 1, 1999, and December 31, 2021. RESULTS: We evaluated 98 sebaceous neoplasms: 64 tumors (32 adenomas, 2 sebaceomas, 5 atypical sebaceous neoplasms, 25 carcinomas) had sufficient material for WGS, 96 tumors (42 adenomas, 11 sebaceomas, 8 atypical sebaceous neoplasms, 35 carcinomas) had sufficient material for WTS, and 62 tumors (31 adenomas, 2 sebaceomas, 5 atypical sebaceous neoplasms, 24 carcinomas) had sufficient material for combined WGS and WTS. Overall, we found decreased cholesterol biosynthesis and increased TP53 mutations, copy number gains (chromosome 6, 8q, and/or 18), and tumor mutation burden-high (>10 mutations/MB) in carcinomas compared to adenomas. Although diminished compared to adenomas, most carcinomas still had higher cholesterol biosynthesis than nonmalignant skin. Multiomics profiling also supported a precancerous model of tumor evolution with sebaceomas and atypical sebaceous neoplasms being likely intermediate lesions. CONCLUSIONS: The study findings highlight key diagnostic biomarkers for sebaceous carcinoma and suggest that immunotherapy and modulation of cholesterol biosynthesis could be effective treatment strategies.

17.
J Cutan Pathol ; 39(8): 777-80, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22765523

RESUMO

Cutaneous deciduosis represents a rare manifestation of cutaneous endometriosis in which typical endometrial glands and stroma are morphologically and physiologically transformed under hormonal influence. The transformed glands and stroma usually take on the microscopic appearance of uterine decidua but may mimic malignancy. We describe two cases of cutaneous deciduosis that presented in the post-partum period, but biopsies were not performed until a much later date. The first lesion arose on the perineum of a 31-year-old female after vaginal delivery, but a biopsy was not performed until 6 years after presentation. The second lesion grew in a cesarean section scar of a 26-year-old female with a history of ovarian adnexal endometriosis. Clinically described as a persistent post-operative hematoma, the lesion throbbed in synchrony with her menstrual cycles; a biopsy was also performed 6 years after presentation. Histopathologically, both specimens showed similar findings. Sections showed a multinodular proliferation of pale-staining epithelioid cells without significant nuclear atypia or conspicuous mitotic figures. Both showed focal glands that ranged from slit-like to slightly dilated and that contained a flattened epithelial lining without atypia. These unusual cases are presented to instruct about the pathologic findings of this entity in order to prevent the unnecessary diagnosis of malignancy.


Assuntos
Decídua/patologia , Endometriose/diagnóstico , Dermatopatias/diagnóstico , Parede Abdominal/patologia , Adulto , Biomarcadores/metabolismo , Cesárea , Cicatriz/patologia , Decídua/metabolismo , Diagnóstico Diferencial , Endometriose/metabolismo , Células Epitelioides/metabolismo , Células Epitelioides/patologia , Feminino , Humanos , Períneo/patologia , Período Pós-Parto , Pele/metabolismo , Pele/patologia , Dermatopatias/metabolismo , Neoplasias Cutâneas/diagnóstico
18.
Am J Dermatopathol ; 34(3): 305-9, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22317889

RESUMO

Apocrine nevus is a rare tumor composed of increased mature apocrine glands and ductal structures within a fibrous stroma, located predominantly in the reticular dermis. They have been reported in association with apocrine carcinoma, extramammary Paget disease, and syringocystadenoma papilliferum; less commonly a pure apocrine nevus is identified, unassociated with another apocrine proliferation. Clinically apocrine nevi may appear as solitary or multiple nodules or plaques on the scalp, presternal skin, though they are seen most commonly in the axillae. We describe 4 cases of pure apocrine nevus, all of which appeared clinically as painless or mildly tender skin-colored axillary masses, 2 of which were bilateral. In each case, the lesions appeared in adulthood, and patients denied knowledge of congenital or childhood presence. Patients denied pruritis, discharge, bleeding, or antecedent trauma. Grossly, the specimens consisted of subcutaneous, multicystic ill-defined nodules. Biopsy showed prominent apocrine glands composed of irregularly columnar luminal cells with eosinophilic cytoplasm arranged in a somewhat organoid pattern filling the reticular dermis and extending into the subcutaneous adipose tissue. The glandular luminal cells displayed decapitation secretion. There was a paucity of pilosebaceous units. In one case, the overlying epidermis was papillomatous. The deepest portion of one specimen had lactational change simulating a lactational adenoma. No atypia was seen in either the glandular structures or the stroma. The adjacent sebaceous and eccrine structures were normal. The histologic features and immunohistochemical profile in relation to other apocrine lesions will be reviewed.


Assuntos
Glândulas Apócrinas/patologia , Hamartoma/patologia , Nevo/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico , Adulto , Glândulas Apócrinas/metabolismo , Glândulas Apócrinas/cirurgia , Biomarcadores Tumorais , Biópsia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nevo/metabolismo , Nevo/cirurgia , Neoplasias das Glândulas Sudoríparas/metabolismo , Neoplasias das Glândulas Sudoríparas/cirurgia , Resultado do Tratamento , Adulto Jovem
19.
PLoS One ; 17(10): e0275185, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36223342

RESUMO

BACKGROUND: Adverse Childhood Experiences (ACEs) include potentially traumatic exposures to neglect, abuse, and household problems involving substance abuse, mental illness, divorce, incarceration, and death. Past study findings suggest ACEs contribute to depression, while physical activity alleviates depression. Little is known about the link between ACEs and physical activity as it relates to depression among U.S. adults. This research had a primary objective of determining the role of physical activity within the link between ACEs and depression. The significance of this study involves examining physical activity as a form of behavioral medicine. METHODS: Data from the 2020 Behavioral Risk Factor Surveillance System were fit to Pearson chi-square and multivariable logistic regression models to examine the links between ACEs and depression, ACEs and physical activity, and physical activity and depression among U.S. adults ages 18-and-older (n = 117,204) from 21 states and the District of Columbia, while also determining whether physical activity attenuates the association between ACEs and depression. RESULTS: Findings from chi-square analyses indicated that ACEs are related to physical activity (χ2 = 19.4, df = 1; p<0.01) and depression (χ2 = 6,841.6, df = 1; p<0.0001). Regression findings suggest ACEs were linked to depression (AOR = 1.050; 95% CI = 1.049, 1.051). ACEs and physical activity (AOR = 0.994; 95% CI = 0.992, 0.995) and physical activity and depression (AOR = 0.927; 95% CI = 0.922, 0.932) were both inversely related. Physical activity mitigated the link between ACEs and depression (AOR = 0.995; 95% CI = 0.993, 0.996). CONCLUSIONS: This research addressed a critical knowledge gap concerning how ACEs and physical activity contribute to depression outcomes among U.S. adults. Findings suggest physical activity mitigates the effect of ACEs on depression. Future studies should apply physical activity interventions to alleviate depression among U.S. adults with high ACEs.


Assuntos
Experiências Adversas da Infância , Maus-Tratos Infantis , Adolescente , Adulto , Criança , Depressão/epidemiologia , Exercício Físico , Humanos
20.
Nutr Rev ; 80(10): 2089-2099, 2022 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-35535026

RESUMO

CONTEXT: Food insecurity (FI) and adverse childhood experiences (ACEs) disproportionally affect vulnerable populations and are key social determinants of health that predict nutrition-related outcomes. It is critical to understand how FI and ACEs are interrelated so prevention studies can be designed to better promote health equity. OBJECTIVE: A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to determine the association between FI and ACEs. DATA SOURCES: Google Scholar, PubMed, and Scopus databases were used to find articles relevant to the study. Inclusion criteria included quantitative, qualitative, or mixed-methods studies of humans, using an experimental or observational research design to examine the relationship between FI and ACEs using the validated ACEs measure in its entirety. DATA EXTRACTION: Studies were assessed for study design, data set, population descriptions, and results of the association between FI and ACEs. Additionally, all included studies were assessed for bias and validity. DATA ANALYSIS: A total of 10 articles were included in the systematic review. Of those articles, 9 were reports on cross-sectional studies, and 1 reported on a longitudinal study; however, all 10 studies used a retrospective approach. Six studies were conducted using secondary data. Results reported in all 10 articles indicated a significant positive association between FI and ACEs. Evidence indicated greater odds of FI among individuals with high ACE scores, with most studies indicating a dose-response or a threshold effect of higher ACEs being associated with more severe FI. CONCLUSIONS: FI and ACEs are consistently related. Prevention study interventions should be designed to address FI and problems stemming from ACEs. Filling knowledge gaps regarding the relationship between ACEs and FI is critical for designing nutrition interventions that promote food security, prevent the occurrence of ACEs, and improve health outcomes among vulnerable populations with high ACEs. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no.: CRD42020210106.


Assuntos
Insegurança Alimentar , Promoção da Saúde , Estudos Transversais , Humanos , Estudos Longitudinais , Estudos Retrospectivos
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