Cutaneous Metastases from Primary Liver Cancers: The Need for Knowledge and Differential Diagnosis.

Primary skin tumors are certainly more frequent than metastatic tumors, but the latter can sometimes be the first sign of otherwise unrecognized neoplastic pathology and always correspond to an advanced stage of the disease. Among the various neoplasms that can metastasize in cutaneous districts, skin metastases from primary malignant neoplasms from the liver and biliary tract are infrequent, and when they do occur they can pose differential diagnosis problems to the pathologist. Here we present two cases of metastatic skin lesions, respectively originating from the liver and the intrahepatic biliary tract, and we conduct a brief review of the current literature.

The enigmatic fascia: eosinophilic fasciitis.

This case report highlights the potentially underrecognized subtype of unilateral eosinophilic fasciitis (EF) in a 28 year old man. With fewer than 300 reported encounters to date, EF is a rare disease that eludes clinicians by presenting as a scleroderma like syndrome. As EF remains a clinical diagnosis, biopsy results may be nonspecific, and the disease can easily be misdiagnosed (or missed entirely) if a full thickness biopsy is not reviewed by a dermatopathologist. The authors also emphasize the importance of internationally accepted diagnostic criteria, of which at least two different sets exist.

CARACTERIZACIÓN CLÍNICA, HISTOPATOLÓGICA E HISTOQUÍMICA DEL PAPILOMA CUTÁNEO EN BOVINOS (Bos taurus) DEL DEPARTAMENTO DE CÓRDOBA, COLOMBIA / CLINICAL, HISTOPATHOLOGICAL AND HISTOCHEMICAL CHARACTERIZATION OF CUTANEOUS PAPILLOMATOSIS IN BOVINE (Bos taurus) OF CÓRDOBA DEPARTMENT, COLOMBIA

RESUMEN El objetivo de este trabajo fue estudiar los aspectos clínicos, histopatológicos e histoquímicos de la papilomatosis cutánea (PC) en bovinos (Bos taurus), del departamento de Córdoba, Colombia. Dicho estudio fue de tipo descriptivo, no probabilístico, en animales de conveniencia. Se utilizaron 24 bovinos con PCB, diagnosticados clínica e histopatológicamente. Las lesiones, se observaron a modo de masas exofíticas e hiperpigmentadas; en algunos casos, pediculadas o en forma de coliflor; en otros e inclusive en los papilomas planos, se evidenciaron los pedículos a la compresión. De igual forma, los papilomas de gran tamaño pendulantes fueron extraídos quirúrgicamente que, al ser diseccionados, se evidenció la hiperplasia epitelial, la hiperqueratosis y la proyección de la epidermis hacia la dermis. A nivel de cabeza, la mayor presentación se dio en boca, en orejas, en frente y en párpados. Histopatológicamente, en la coloración de H-E, se observó hiperplasia epitelial, acantosis, proyecciones digitales hacía la dermis e hiperqueratosis. En la coloración de T-G, se observó marcada proliferación dérmica de colágeno desorganizado, con escasa presencia de tejido conjuntivo difuso y en la coloración de P-R/P, se observaron marcadas áreas de birrefringencia rojiza y escasa birrefringencia verdeamarillenta. El diagnóstico definitivo de la enfermedad, se fundamentó en las características clínicas, diagnóstico diferencial y en los hallazgos histopatológicos, siendo concluyentes, como métodos de diagnóstico de la PC en bovinos, del Departamento de Córdoba.

SUMMARY The objective of this study was to study the clinical, histopathological and histochemical aspects of cutaneous papillomatosis (CP) in cattle (Bos taurus) of the department of Córdoba, Colombia. This study was descriptive, not probabilistic, in animals of convenience. Were used Twenty four bovines with BCP diagnosed clinically and histopathologically. In describing the lesions exophytic and hyperpigmented masses were observed in some cases, pedicled or in the form of cauliflower in others and even in the flat papillomas showed the pedicles to the compression. Similarly, large pendulum papillomas were surgically removed, which when dissected revealed epithelial hyperplasia, hyperkeratosis and the projection of the epidermis to the dermis. At head level, the largest presentation was given in mouth, ears, forehead and eyelids. Histopathologically in the H-E staining, were observed epithelial hyperplasia, acanthosis, digital projections to the dermis and hyperkeratosis. In the T-G staining, marked dermal proliferation of disorganized collagen with little diffuse connective tissue was present, and in the P-R / P staining, marked areas of reddish birefringence and scarce birefringence were observed. The definitive diagnosis of the disease was based on the clinical characteristics, differential diagnosis and histopathological findings, being conclusive as diagnostic methods for CP in bovines in the Department of Córdoba.

Porokeratosis ptychotropica

Abstract Porokeratosis is a skin disorder clinically characterized by annular plaques with keratotic borders resembling the Great Wall of China and histopathologically by cornoid lamellae. The disease has several clinical variants. Porokeratosis ptychotropica, which has recently become part of these variants, is quite rare and little known. The entity is characterized by verrucous plaques – which may resemble a psoriasis plaque – that affect the regions of the buttocks, most commonly the gluteal cleft, with or without extremity involvement. Itching is often present. We report a rare case of porokeratosis ptychotropica and highlight its unusual manifestation (single plaque), the first case reported in the Brazilian literature.

Review of Cutaneous Graft-vs-Host Disease.

Graft-vs-host disease (GVHD) is a multisystem disease that arises as a complication of allogeneic hematopoietic stem cell transplant. It is due to recognition of the recipient's tissues by immune cells from the donor. The skin and mucous membranes are the organs most commonly affected. GVHD is classified as acute or chronic depending on the pathophysiology and clinical presentation. Acute GVHD typically presents with the triad of rash, diarrhea, and hyperbilirubinemia, and treatment is based on systemic corticosteroid and immunosuppressant therapy. The cutaneous manifestations of chronic GVHD are divided into sclerodermiform and nonsclerodermiform, and the mucous membranes and skin appendages may also be affected. The diagnosis is mainly clinical, but skin biopsy can help in doubtful cases. Treatment can be topical, systemic, or physical, depending on the size, site, and depth of the lesions and the involvement of other organs.