Cytokeratin Profile of Basal Cell Carcinomas According to the Degree of Sun Exposure and to the Anatomical Localization.

Basal cell carcinoma (BCC) seems to originate from ultraviolet light-induced mutations involving the bulge or the outer sheath of the hair follicle cells. However, the etiopathogenic mechanisms involved in the development of these tumors in nonphotoexposed and in hairless areas remain unclear. The cytokeratin (CK) profile (including CK5/6, CK7, CK14, CK15, CK17, and CK19) from a series of different BCC subtypes developing in sun-exposed and non-sun-exposed areas, including hairless regions, was evaluated. The authors have observed that CK7 expression in BCC is associated with the anatomical localization of the tumor and its sun-exposition, but not with other factors such as histological subtype. The expression of this CK is higher in BCCs located in non-sun-exposed and nonhairy areas, such as the vulvar semimucosa and the nipple. Because CK7 is a marker of simple glandular epithelia, the authors suggest a glandular origin for BCCs located in hairless and nonphotoexposed areas.

Microcystic Adnexal Carcinoma and a Summary of Other Rare Malignant Adnexal Tumours.

OPINION STATEMENT: Microcystic adnexal carcinoma (MAC) is a rare, slow-growing, infiltrative malignant tumour most commonly found on the head and neck. It often presents as a solitary skin-coloured or yellow papule, plaque or nodule. Ultraviolet radiation, immunosuppression and ionising radiation are possible risk factors. Clinical and histological differential diagnoses include morpheaform basal cell carcinoma and desmoplastic trichoepithelioma. The diagnosis is usually made by skin biopsy, and the characteristic features are small keratin-filled cysts with nests and cords which resemble ductal structures. Immunohistochemistry can assist in differentiating MAC from other tumours. The local aggressive nature of the tumour and its potential to infiltrate beyond the assessed clinical margins warrant complete excision with marginal control, and we recommend Mohs micrographic surgery. Wide local excision is widely performed but is associated with recurrence given its infiltrative nature and extensive subclinical extension. The role of radiotherapy in the management of MAC is unclear.

Dermatofibromas eruptivos múltiplos einfecção pelo HCV tratada com interferon / Multiple eruptive dermatofibromas and HCV infection treated by interferon

O dermatofibroma é um tumor fibrohistiocístico benigno comum. Os dermatofibromas eruptivos múltiplos são definidos arbitrariamente pela presença de 15 ou mais dermatofibromas ou pelo desenvolvimento de 5 a 8 destes em um período menor do que 4 meses. A patogênese dos dermatofibromas eruptivos múltiplos ainda permanece incerta, mas há estudos que relacionam seu aparecimento a determinadas doenças auto-imunes, doenças infecciosas e uso de imunomoduladores. É importante pesquisar e reconhecer o quadro descrito como dermatofibromas eruptivos múltiplos, pois ele pode ser indicativo de importante condição subjacente. Nosso relato descreve o caso de um homem portador do vírus da hepatite C que fez uso de alfa-interferon e que, posteriormente, desenvolveu múltiplos dermatofibromas. No contexto da infecção pelo HCV e do uso de interferon, o quadro de DEM poderia estar relacionado à infecção propriamente dita e/ou a um efeito idiossincrásico da droga

Dermatofibroma is a common benign fibrohistiocystic tumor. Multiple eruptive dermatofibromas are defined arbitrarily as more than 15 dermatofibromas or 5 to 8 dermatofibromas developing over a span of less than 4 months. A etiology is unknown, but there are studies that relate their appearance to determined self-immune illnesses, infectious illnesses and use of immunomodulators. It is important to search and to recognize the described picture as multiple eruptive dermatofibromas, therefore it can be indicative of important underlying condition. Our story describes the case of a carrying man of HCV that made alpha-interferon use and that, later developed multiples dermatofibromas. In the context of the infection for the HCV and the use of interferon, the multiple eruptive dermatofibromas picture could be related to the infection properly said and/or an idiosyncratic effect of the drug

Diffuse fibrous pseudotumor of the testicular tunics associated with an inflamed hydrocele.

Fibrous pseudotumors of the testicular tunics and paratesticular soft tissue are uncommon lesions. They typically arise as painless scrotal masses that may be associated with a hydrocele or history of trauma or infection. Although these lesions are clinically worrisome for a malignant neoplasm, they are thought to be reactive in nature, since they are composed of dense fibrous tissue with interspersed bland fibroblasts and myofibroblasts and mixed inflammatory cells. Once excised, these lesions behave in a benign fashion. Typically, these masses are multinodular, but in rare cases they are diffuse, bandlike myofibroblastic proliferations that encase the testis and are termed fibromatous periorchitis. Herein, we describe a 57-year-old man with a diffuse fibrous pseudotumor/fibromatous periorchitis that encased the left testis and adnexa and arose in close apposition to an inflamed hydrocele.

Trichilemmal carcinoma in an African American.

BACKGROUND: Trichilemmal carcinoma is an uncommon cutaneous neoplasm found primarily on the sun-exposed skin of the elderly. OBJECTIVE: To report a case of trichilemmal carcinoma presenting as a forehead nodule in an African American patient. METHODS: Case report and review of the literature. RESULTS: Our patient is the first reported case in the English language literature of trichilemmal carcinoma in an African American individual with skin phototype VI. CONCLUSION: The occurrence of trichilemmal carcinoma in our African American patient suggests the diagnosis of trichilemmal carcinoma be added to the differential diagnosis of a nodule on the head region in this patient population.