Onychodystrophy and tumor-stage mycosis fungoides confined to a single digit: report of a case and review of nail findings in cutaneous T-cell lymphoma.

Mycosis fungoides is often considered one of the great disease imitators presenting with a wide variety of clinical manifestations. We present a case of tumor-stage mycosis fungoides involving a single digit clinically presenting with diffuse swelling of the digit and onychodystrophy. Histologic findings included a reticular dermal lymphocytic infiltrate with increased ratio of CD4:CD8 cells. The patient was treated with radiation resulting in complete resolution. Nail involvement with mycosis fungoides has been scarcely reported, but when present ranges from 20-nail dystrophy to yellow discoloration. The disease often involves most of the nails when present.

Androgen receptor expression patterns in Becker's nevi: an immunohistochemical study.

BACKGROUND: Becker's nevus (BN) is a hyperpigmented patch that traditionally presents on the upper torso in adolescent males. Previous studies have reported an association with increased androgen receptors (ARs) in lesional skin in men and women who have associated physical abnormalities. OBJECTIVE: This study was conducted to assess the presence of ARs immunohistochemically in female patients with BN but no other physical abnormalities and compare this finding with BN in males and in normal skin. METHODS: Biopsy specimens from Becker's nevi in 3 women and 3 men as well as normal skin in the 3 female subjects were stained with AR antibody, and the level of expression in various cutaneous structures was measured. RESULTS: ARs were increased in dermal fibroblasts in Becker's nevi compared to that found in normal skin. LIMITATIONS: The major limitation of the study was the small sample size. CONCLUSION: In BN there is increased AR expression in dermal fibroblasts; immunohistochemical staining may aid in making the biopsy diagnosis.

Prognostic significance of extent of ulceration in primary cutaneous melanoma.

Ulceration has been shown to be an adverse prognostic factor in primary cutaneous melanoma. However, the extent of ulceration required for histologic identification and biologic significance is unclear. We examined the impact of extent of ulceration on melanoma outcome in a cohort of 235 melanoma patients by evaluating the relationship between percentage of ulceration in the vertical growth phase of the primary tumor and 2 outcome parameters: sentinel lymph node status and overall survival. We measured the diameter of the ulcerated area in millimeters over the diameter of the entire vertical growth phase. There was a statistically significant relationship between increasing percentage of tumor ulceration and both sentinel lymph node status as well as overall survival, with a binary cut-off point of 2% for sentinel lymph node status and 5% for overall survival. The percentage of ulceration provides additional prognostic information in predicting sentinel lymph node status and in determining survival in melanoma patients. These results suggest that no more than minimal ulceration is required to have a prognostic impact on melanoma survival.