ABSTRACT
ABSTRACT: Central centrifugal cicatricial alopecia (CCCA) is a scarring alopecia that disproportionately affects patients with skin of color. Genetic studies have revealed that approximately 30% of CCCAs are associated with peptidyl arginine deiminase 3 misfolding mutations. Patients with CCCA usually have a poor prognosis with progressive and permanent hair loss. To further characterize CCCA, we evaluated the inflammatory milieu, PDL1, and caspase 3 expression. The data support the idea of CCCA being a CD4-predominant T-cell process. The loss of PDL1 and increase in caspase 3 expression raises the possibility of involvement of the PD1/PDL1 pathway in CCCA.
Subject(s)
Alopecia , Dermatitis , Humans , Caspase 3 , Alopecia/genetics , Mutation , Cicatrix/pathologyABSTRACT
ABSTRACT: Neurothekeoma, a lesion of possible fibrohistiocytic origin, is a rare, benign, superficial soft tissue tumor, histologically subclassified in 3 types: myxoid, cellular, or mixed. It clinically presents as a solitary, pink to brown nodule, ranging from 0.3 to 2.0 cm. Four point mutations (PI3K w552*, ALK P1469S, SMO G461S, and ERBB3 L77M) were identified by next-generation sequencing of a neurothekeoma presenting in the left inner thigh of a 53-year-old man. We highlight novel genetic alterations (SMO G461S and ERBB3 L77M) and previously known mutations (PI3KCA w552* and ALK P1469S) that play a role in other pathogenic pathways, but to the best of our knowledge, these have not yet been reported in neurothekeoma.
Subject(s)
Neurothekeoma , Soft Tissue Neoplasms , Male , Humans , Middle Aged , Neurothekeoma/genetics , Neurothekeoma/metabolism , Neurothekeoma/pathology , Phosphatidylinositol 3-Kinases , Immunohistochemistry , Point Mutation , Receptor Protein-Tyrosine Kinases , Smoothened Receptor , Receptor, ErbB-3/geneticsABSTRACT
ABSTRACT: Basal cell carcinoma (BCC) is the most commonly diagnosed cutaneous cancer in the United States with more than 2.5 million treated annually. Genetic studies have revealed that approximately 90% of BCCs have a mutation in the hedgehog-signaling pathway. Patients with BCC usually have an excellent prognosis with surgical modalities, however, patients with locally advanced BCC may potentially experience significant cosmetic or functional impairment, with only surgical intervention. Vismodegib is a hedgehog pathway inhibitor that has been successful in treating patients with locally advanced BCC. We report a patient with BCC with a good response to vismodegib and a novel xanthomatous change in the excision specimen.
Subject(s)
Anilides/therapeutic use , Antineoplastic Agents/therapeutic use , Carcinoma, Basal Cell/drug therapy , Carcinoma, Basal Cell/pathology , Neoplasms, Second Primary/drug therapy , Pyridines/therapeutic use , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology , Aged , Carcinoma, Basal Cell/surgery , Humans , Male , Neoplasms, Second Primary/pathology , Neoplasms, Second Primary/surgery , Skin Neoplasms/surgery , Xanthomatosis/pathologySubject(s)
Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Lymphoma, B-Cell, Marginal Zone/pathology , Plasma Cells/pathology , Skin Neoplasms/pathology , Aged, 80 and over , Antineoplastic Agents, Immunological/therapeutic use , Biopsy , Cell Differentiation , Diagnosis, Differential , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Leukemia, Lymphocytic, Chronic, B-Cell/genetics , Leukemia, Lymphocytic, Chronic, B-Cell/immunology , Lymphoma, B-Cell, Marginal Zone/genetics , Lymphoma, B-Cell, Marginal Zone/immunology , Male , Plasma Cells/immunology , Predictive Value of Tests , Rituximab/therapeutic use , Skin Neoplasms/drug therapy , Skin Neoplasms/genetics , Skin Neoplasms/immunology , Treatment OutcomeABSTRACT
Human polyomavirus-7-associated rash and pruritus (PVARP) is a chronic superficial viral skin infection, which primarily impacts immunocompromised individuals. We report on a case of PVARP in a lung transplant recipient. Our patient developed symptoms 13 years after being on his immunosuppressive regimen, with an insidious course of progressive gray lichenification with marked islands of sparing and quality of life-altering pruritus. Treatment for PVARP is not established; however, topical cidofovir combined with immunomodulation may offer sustained therapeutic benefit.
