Primary Cutaneous Adenoid Cystic Carcinoma: A Misdiagnosed Tumor.

Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare, slow-growing adnexal skin tumor with about 250 documented cases. We present a case involving a 66-year-old woman who was treated with ovulation inductors 30 years ago and underwent surgeries for meningioma 20 years ago and invasive galactophoric adenocarcinoma of the left breast 12 years ago. She presented with a gradually enlarging, solid, skin-colored tumor on her scalp, located along an old surgical scar initially diagnosed as a keloid by her surgeon. Clinical and dermoscopic evaluations suggested basal cell carcinoma or a metastatic tumor. Confocal microscopy showed deep infiltration without specific diagnostic clues. However, histopathological examination, immunohistochemistry, and comprehensive investigations confirmed the diagnosis of PCACC. A wide local excision was performed, with no recurrence noted during the two-year follow-up. This case highlights the challenges of diagnosing PCACC through clinical, dermoscopic, and confocal methods. Histological analysis remains essential, particularly to distinguish it from metastatic lesions, emphasizing the need for a thorough diagnostic approach in such cases.

Primary Cutaneous Malignant Perivascular Epithelioïd Cell Tumor (PEComa): Case Report With Review of the Literature.

Perivascular epithelioïd cell tumor (PEComa) is a mesenchymal neoplasm with epithelioïd or spindled morphology with numerous thin-walled capillaries between tumor cells. They co-express markers of both melanocytic and smooth muscle differentiation. PEComas are rare, presenting in numerous anatomic sites including lung, kidney, liver, genitourinary tract, soft tissue, and skin. Primary cutaneous PEComas are very rare entity, and malignant ones are even more uncommon. Herein, we report the case of a 92-year-old female which was presenting with 7 cm exophytic, ulcerated, hemorrhagic nodular tumor, and rapidly growing for 8 months over the right thigh. On histologic examination, we found a dermal neoplasm formed by an atypical clear cell tumor with numerous branching capillaries between tumor cells. The mitotic count was found 6 mitotic figures/10 HPF. On immunohistochemistry, tumor cells co-expressed smooth muscle and melanocytic markers, CD10, and CD68. Based on these findings, the diagnosis of primary cutaneous malignant perivascular epithelioïd cell tumor (PEComa) was made. The large size (7 cm), the count of mitoses (6 mitotic figures/10 HPF), and the nuclear pleomorphism argued for malignancy. The absence of soft tissue or visceral localization argued for the cutaneous primitive origin. Adjuvant radiotherapy and targeted therapy with mTOR inhibitor (nab-sirolimus) was indicated. To the best of our knowledge, this is only the eighth case of a primary cutaneous malignant PEComa reported in the literature to date.

Multifocal tuberculosis revealed by multiple cutaneous gummas in the immunocompetent.

Cutaneous tuberculosis is rare. Its occurrence in multifocal tuberculosis (MT) is uncommon and happens frequently in the context of immunosuppression. We report the case of MT with multiple cutaneous gummas and bone and lung involvement that occurred in an apparently immunocompetent patient.

[Descriptive dermoscopic study of a series of 100 patients with basal cell carcinoma diagnosed in Morocco]. / Étude descriptive dermoscopique d'une série de 100 carcinome basocellulaires diagnostiqués au Maroc.

INTRODUCTION: Dermatoscopy is an innovative non-invasive technique for clinical morphology of pigmented lesions and skin tumor. The purpose of our study was to highlight the morphological and dermoscopic features of basal cell carcinoma (CBC) in our study population. METHODS: We conducted a prospective unicentric study over a period of 2 years. We used dermoscopy in all patients with BCC. Statistical analysis was performed using SPSS software version 17. RESULTS: The study included 100 patients with BCC, the average age of patients was 51.87 years, with a sex ratio F/M = 0.6. BCC most commonly occurred in the face and most patients were prototype III and IV. We established conventional and non-conventional dermatoscopic criteria. Our study showed that there is a significant relationship between prototype and the degree of BCC pigmentation. CONCLUSION: This study highlighted the key role of dermoscopy in detecting small-sized BCC and in facilitating the diagnosis of pigmented BCC.

Cutaneous leukocytoclastic vasculitis revealing multifocal tuberculosis.

Cutaneous leukocytoclastic vasculitis (CLV) is an inflammatory vascular disorder rarely reported to be associated with tuberculosis. The following report describes the case of a young man with multifocal tuberculosis revealed by CLV. Diagnosis was confirmed by the presence of tuberculoid granuloma with caseous necrosis on pleural and perianal biopsy, and a rapid improvement in anti-tuberculous quadritherapy. Although rarely seen, Mycobacterium tuberculosis should be considered as a potential cause of CLV.