RESUMO
There is a significant need for the development of diagnostic tools that can precisely distinguish Spitz nevi and spitzoid melanomas. Here, we report the development of a PCR-based quantitative diagnostic assay for spitzoid melanocytic lesions utilizing the expression ratio of neuropilin-2 and melan-A genes in primary tumor specimens. We find that the expression ratio of neuropilin-2/melan-A is significantly increased in spitzoid melanomas compared with Spitz nevi. The diagnostic potential of this quantitative assay was validated in two independent sets of patient samples as demonstrated in a receiver operating characteristic curve analysis showing an area under the curve value of 91.8%. Furthermore, the assay was found to quantitatively distinguish the clinical nature of atypical spitzoid melanocytic lesions that were diagnostically undetermined using histopathologic criteria alone. Our data indicate that this quantitative assay may be used as a tool in determining the diagnostic classification of histologically challenging spitzoid tumors.
Assuntos
Biomarcadores Tumorais/genética , Testes Diagnósticos de Rotina/métodos , Melanócitos/patologia , Melanoma/diagnóstico , Neuropilina-2/genética , Nevo de Células Epitelioides e Fusiformes/diagnóstico , Biomarcadores Tumorais/análise , Diagnóstico Diferencial , Humanos , Melanócitos/metabolismo , Melanoma/genética , Nevo de Células Epitelioides e Fusiformes/genéticaAssuntos
Epiderme/patologia , Fibrose/patologia , Ceratoacantoma/patologia , Ceratoacantoma/terapia , Biópsia por Agulha , Feminino , Fibrose/diagnóstico , Humanos , Imuno-Histoquímica , Ceratoacantoma/diagnóstico , Ceratolíticos/uso terapêutico , Pessoa de Meia-Idade , Cirurgia de Mohs/métodos , Fotoquimioterapia , Prognóstico , Dermatopatias/diagnóstico , Dermatopatias/patologia , Coxa da Perna , Resultado do TratamentoRESUMO
The term rupioid has been used to describe well-demarcated, cone-shaped plaques with thick, dark, lamellate, and adherent crusts on the skin that somewhat resemble oyster or limpet shells. We present a case of rupioid psoriasis that was treated with methotrexate, topical steroids, and intralesional steroid injections. Rupioid manifestations have been clinically observed in a variety of disease settings, including rupioid psoriasis, reactive arthritis, disseminated histoplasmosis, keratotic scabies, secondary syphilis, and photosensitive skin lesions in association with aminoaciduria. To diagnose the underlying infectious or inflammatory diseases beneath the thick crusts, skin biopsy and a blood test for syphilis may be necessary. Our aim is to familiarize clinicians with the differential diagnoses for skin diseases with rupioid manifestations.