Primary cutaneous perivascular epithelioid cell tumors: two cases and a review of the literature.

Report _Case Presentation _Photo Vignette _Letter Authors declare that the contents of this article are their own original unpublished findings. Title: Primary cutaneous perivascular epithelioid cell tumors: two cases and a review of the literature Authors: Jennifer Wong1 DO, Jason Mammino2 DO, Jennifer Seyffert3 DO, Kristen Schmits4 MD, Etan Marks4 MD, Daniel Rivlin3 MD Affiliations: 1Department of Dermatology, LECOM- Larkin Community Hospital, Miami, Florida, USA, 2Department of Dermatology, KCUMB - Advanced Dermatology and Cosmetic Surgery, Orlando, Florida, USA, 3Department of Dermatology, LECOM- Skin and Cancer Associates, Miami Beach, Florida, USA, 4Department of Dermatopathology Advanced Dermatology and Cosmetic Surgery Pathology Laboratory, Delray Beach, Florida, USA Corresponding Author: Jennifer Seyffert DO, 4308 Alton Road, Suite 510, Miami Beach, FL 33140, Tel: 305-674-8865, Fax: 305-674-1459, Email: jseyf12@gmail.com Abstract: Perivascular epithelioid cell tumors, also known as PEComas, are mesenchymal neoplasms which uncommonly originate within the skin, with only 23 cases documented within the literature. These rare neoplasms classically display epithelioid cells composed of granular or clear cytoplasm arranged in sheets, nests, or cords. Their immunoreactivity for melanocytic and smooth muscle markers makes these tumors distinct and unique.[1] We herein present two cases of primary cutaneous PEComas that clinically mimic other common cutaneous neoplasms and illustrate the necessity for clinical-pathologic correlation. A literature review is also presented to compare the different clinical and histological presentations of cutaneous PEComas.

Lichen Planus With Predominate Plasma Cell Infiltrate: Two Case Reports.

Lichen planus (LP) is a mucocutaneous inflammatory dermatitis of idiopathic origin that can involve the skin, mucous membranes, hair, and nails. LP has an associated set of characteristic histopathologic findings which include hyperkeratosis, vacuolization of the basal layer, Civatte bodies, wedge-shaped hypergranulosis, band-like lymphocytic infiltrate at the dermal epidermal junction, eosinophilic colloid bodies in the papillary dermis, and pigment incontinence. The infiltrate is usually composed of lymphocytes with few histiocytes, mast cells, and macrophages. The presence of plasma cell predominant infiltrate in LP has only been reported in four previous cases and 2 other cases of lichen nitidus. The authors report another 2 cases of LP with predominate plasma cell infiltrate in 2 female patients on the legs. The differential includes a drug-induced lichenoid reaction with predominate plasma cell infiltrate. However, there have been no case reports of that type of reaction. Because plasma cells are seen commonly in certain infectious diseases, malignancy, and macroglobulinemia, it is prudent to rule out those entities. Our patients responded well with a class 1 topical steroid, with improvement of their lower leg lesions within 1 month of treatment.