Preliminary evaluation of in vivo reflectance confocal microscopy features of Kaposi's sarcoma.

BACKGROUND: Kaposi's sarcoma (KS) is an unusual, clinically polymorphic, vascular neoplasm with genetic, infectious, environmental and immunological pathogenesis. Reflectance confocal microscopy (RCM) made in vivo noninvasive imaging of the skin possible and has been used for the evaluation of several skin diseases offering important microscopic information. OBJECTIVE: The purpose of our study is to describe the RCM features of KS and correlate them with histopathology evaluating the effective prediction attitude and repeatability of RCM. METHODS: Twelve KS lesions underwent RCM followed by histological examination. Data obtained were statistically correlated. RESULTS: Analysis of the incidence of 11 selected microscopic criteria (by RCM and optical histology: inflammatory cells in the epidermis and in the dermis, single or in aggregates; spindle cells; stroma; anastomosing, newborn, increased number and dilated vessels; extravasated erythrocytes; deposits of hemosiderin) was performed disclosing a good correlation and high sensitivity of RCM. CONCLUSION: In our study RCM seems to provide high accuracy to predict histological findings, demonstrating its possible role in the management of patients affected by KS.

Comparing in vivo reflectance confocal microscopy, dermoscopy, and histology of clear-cell acanthoma.

BACKGROUND: Clear cell acanthoma (CCA) is a rare, benign neoplasm of unknown etiology, whose dermoscopic and histological features have been previously described. Usually, CCA can be diagnosed by clinical and dermoscopic examination. In some cases, diagnosis remains uncertain, and histological examination is needed. The aim of this paper was to describe the features of reflectance confocal microscopy (RCM) in diagnosing CCA, compare them with findings on dermoscopy and histology, and evaluate their possible usefulness in CCA evaluation. PATIENTS AND METHODS: Five lesions diagnosed clinically as CCA were imaged using dermoscopy and RCM. All lesions were surgically excised to confirm the diagnosis and compare the morphological attributes under light microscopy with in vivo imaging. RESULTS: RCM showed well-circumscribed lesions, often edged by a hyperkeratotic collarette with parakeratosis; inflammatory cells in the spinous layer; large keratinocytes; acanthosis with papillomatosis; epidermal disarray; and dilated capillaries forming glomeruloid shapes in the upper dermis. CONCLUSIONS: In this small study, RCM was able to identify most of the established diagnostic histological features of CCA. RCM appears to be a useful tool for in vivo diagnosis of CCA and may help avoid unnecessary biopsies.

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

Dermatofibromas eruptivos múltiplos e infecção pelo HCV tratada com Interferon / Multiple eruptive dermatofibromas and HCV infection treated by Interferon

O dermatofibroma é um tumor fibrohistiocístico benigno comum. Os dermatofibromaseruptivos múltiplos são definidos arbitrariamente pela presença de 15 ou mais dermatofibromasou pelo desenvolvimento de 5 a 8 destes em um período menor do que 4meses. 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 oquadro descrito como dermatofibromas eruptivos múltiplos, pois ele pode ser indicativode importante condição subjacente. Nosso relato descreve o caso de um homem portadordo vírus da hepatite C que fez uso de alfa-interferon e que, posteriormente, desenvolveumúltiplos dermatofibromas. No contexto da infecção pelo HCV e do uso de interferon, oquadro de DEM poderia estar relacionado à infecção propriamente dita e/ou a um efeitoidiossincrásico da droga.

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