Erythematosus actinic lichen planus: a new clinical form associated with oral erosive lichen planus and chronic active hepatitis B.
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Biomedical subjects
Publications and source records attributed to B Balme.
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We report a localized form of lymphomatoid papulosis (LyP) presenting as pustular papules of the hands. The histopathology revealed a moderate inflammatory infiltrate composed of atypical pleomorphic large lymphocytes with atypical mitosis and large nuclei. Epidermotropism could be observed. These atypical cells expressed CD4 and CD30. Laboratory examinations and bone marrow explorations remained negative. The clinical presentation of this case of LyP is unusual. Only histopathological features allowed to diagnose LyP. The knowledge that LyP may be associated with neoplasia or lymphoma underlines the need for a long-term follow-up of these patients.
INTRODUCTION: Dermal melanocytosis is characterized by the presence of ectopic melanocytes in the dermis. There are several clinical forms. This report describes an unusual case of acquired dermal melanocytosis probably associated with leptomeningeal melanosis. An ultrastructural study was performed. CASE REPORT: A 52-year-old Caucasian woman presented with a fifteen-year history of slowly spreading gray-blue macular pigmentation, associated with multiple blue nevi. Histologic examination revealed dermal melanocytosis. An extracellular sheath surrounded the melanocyte and their cytoplasmic processes. Medullar magnetic resonance findings were compatible with leptomeningeal melanosis. DISCUSSION: Dermal melanocytosis is thought to represent a disorder of neural crest migration. Melanocytes are thought to be aberrant and become arrested during migration, remaining in the dermis. Reactivation of latent dermal melanocytes should explain the pathogenesis of acquired forms. Ultrastructural examinations show an extracellular sheath enclosing dermal melanocytes in all types of dermal melanocytosis.
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We report a 53-year-old woman who presented with multiple painful red cutaneous papules that had been growing slowly for 13 years. Histopathology showed typical features of neuroma. Biological, morphological and genetic investigations were negative and excluded the diagnosis of multiple endocrine neoplasia type 2b. After reviewing the literature, we concluded that our patient has an extremely unusual acquired disease, which must be considered as a distinct entity in the spectrum of cutaneous neurological disorders.
Emergence of the invasive phenotype is a key event in the progression of human melanoma from benign proliferative lesions to malignant lesions. Recently we successfully selected in vivo from a poorly metastatic M4Beu. human melanoma cell line two variants (7GP and T1P26) that generate a higher frequency of spontaneous metastases to the lungs into immune-suppressed neonatal rats. Both cell lines showed no significant differences in the integrin profile of the subunits analyzed except for beta3, which was reduced to a background level in metastatic variants. To investigate how these variant sublines of human melanomas manage to sustain growth in the absence of alpha(v)beta3, a subtractive immunization approach was used to elicit host antibody response against cell surface proteins expressed on metastatic variants. In this study, a new monoclonal antibody (MoAb), LY1, that is highly specific for the 7GP and T1P26 variants, was isolated. LY1 identifies a membrane protein of Mr 55,000 on melanoma variants with epitopes that were resistant to sugar-cleaving enzymes. Immunostaining cells from variants by LY1 showed that staining is distributed to the cell periphery with high labeling intensity at the cell-to-cell contact points. This MoAb significantly inhibited invasion of metastatic variants through a reconstituted basement membrane (Matrigel) in vitro. Moreover, tumor growth of melanoma variants was dramatically affected in vivo with this MoAb. In vitro studies indicate that the LY1 MoAb does not inhibit chemotactic migration of the metastatic variants, the adhesion of tumor cells to vitronectin, collagen IV, fibronectin, and laminin, or cell proliferation. Expression of this antigen is high in human striated muscle, heart, spleen, brain, and lung and absent in kidney, liver, and pancreas. Using 59 fixed, paraffin-embedded archival tissues of human melanomas and nevi, LY1-reactive cells were not observed in melanocytes, nevi, or radial growth phase primary melanomas. In sharp contrast, LY1 selectively stained melanocytes derived from the vertical growth phase of many primary melanomas and metastatic melanomas. These results provide evidence that the Mr 55,000 protein expressed by selected variants with increased metastatic properties in vivo plays a functionally important role in determining metastasis. This molecule may represent a new metastatic risk marker in human melanoma and may be of biological importance in the identification of fatal metastatic subpopulations that have acquired competence for metastasis production.
The clinical and pathological characteristics of cutaneous melanomas occurring in Camargue-type gray-skinned horses are reported. Examination of 83 tumor-bearing horses revealed that the tumors occurred most frequently underneath the tail (93.9%) and at high rates in the peri-anal region (43.0%), the lips (33.0%), and the eyelids (24.0%), but rarely in the vulva (3.8%). Tumorous lesions were characterized by the presence of either hemispheric nodules or large infiltrated plaques, or their combinations. Microscopic examination indicated that tumorous lesions were composed mostly of melanocytes and numerous melanophages and that component cells manifested a remarkable cellular atypia with anisocytosis and anisokarinosis. Pathological examination of lesions corresponding to earlier stages of the tumors disclosed that tumor formation and its related melanogenesis occurred in close topographical association with apocrine sweat glands, but not at the dermal-epidermal junction. Larger nodules of the tumors were often composed of a concentric deposition of cell layers, each being separated by dermal components from the epidermis. Because of the absence of their tropism toward the epidermis and their multiloculation, horse melanomas are considered to be different in their pathological characteristics from human melanomas.
We report the case of a 69-year-old woman who presented a papular eruption on the eyelids. Histological features revealed a tuberculoid granuloma with a central caseating necrosis. Laboratory and radiological investigations revealed no tuberculosis and no systemic granulomatosis. Absence of vascular symptoms, inefficiency of cyclines and histopathological findings excluded granulomatous-type rosacea. Lupus miliaris disseminatus faciei (LMDF) was our final diagnosis. On the basis of our findings and a literature review, we believe that LMDF is an entity distinct from either skin tuberculosis or granulomatous-type rosacea. However, its name is confusing, and we propose to change it to 'facial idiopathic granulomas with regressive evolution (FIGURE)'.
A 37-year-old man without previous medical history working as a lock keeper was seen in our unit for a progressive painless subcutaneous flesh coloured infiltration of the lower anterior area of the neck growing slowly over 5 months. Clinical cutaneous findings showed a non pruriginous yellowish papulonodular eruption mimicking xanthomas (Figs. 1 and 2). No other clinical abnormalities were found. A cutaneous biopsy specimen was performed. Histopathological examination revealed, under a normal epidermis, a dense lymphoplasmocytoid infiltrate involving the dermis with periadnexal and perivascular reinforcement (Figs. 3 and 4).
BACKGROUND: Primary cutaneous B-cell lymphoma is a heterogeneous group among which marginal zone B-cell lymphoma (MZL) appears to be the most common subtype. OBJECTIVE: We analyze clinical presentation, histologic aspects, and outcome of patients with primary cutaneous MZL. METHODS: All samples classified as primary cutaneous lymphoma over the past 10 years were reviewed, and cases of primary MZL were identified. RESULTS: Nine cases of MZL were analyzed, all from the upper body region, with a predominance in elderly women. Histologic aspects included a dense, nodular, deep-seated infiltrate containing various proportions of small cells displaying a centrocyte-like, plasmacytoid or monocytoid appearance. Surface expression of CD5, CD10, and CD23 was negative. Long survival was noted but relapses in the skin, nodes, orbit, salivary glands, and breast were observed. CONCLUSION: MZL is the predominant primary cutaneous lymphoma of our study. It has distinctive histologic and clinical features as well as outcome.
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Colony-stimulating factors are widely used for bone marrow recovery after chemotherapy. Various cutaneous side-effects have been described in most cases involving neutrophils. We report the first case of lichenoid reaction at injection sites of granulocyte colony-stimulating factor (G-CSF) in a 40-year-old patient treated for breast cancer. The eruption cleared after drug withdrawal, no recurrence was observed after drug replacement by granulocyte-macrophage colony-stimulating factor. Mainly lymphocyte-mediated lichenoid eruption to G-CSF was shown. Cutaneous side-effects to G-CSF do not share unequivocal pathogeny based on stimulation of neutrophils.
We report on a 32-year-old female with a 3-year history of an asymptomatic erythema of the forehead. The lesion had a linear distribution following the lines of Blaschko. Histopathological findings and direct immunofluorescence allowed to establish the diagnosis of cutaneous lupus erythematosus. Treatment with local corticosteroid and antimalarial agents given for 2 months resulted in a complete remission.
We report 2 cases of acquired lymphangiectasias after breast radiosurgical treatment. This well known, rarely reported complication is probably due to a mechanical obstruction of the lymphatic network, and is generally preceded by lymphedema. Our 2 cases, however, did not have previous lymphedema. After a review of the literature, we discuss the role of reparative surgery and other treatment options.
Epithelioid hemangioendothelioma described first by Weiss and Enzinger in 1982 is an uncommon vascular tumor usually involving soft tissue, less frequently the lung and the liver and exceptionally the skin. We herein report a 52-year-old woman who presented an isolated moderately painful persistant ulceration of the concha of her left ear. Histopathological findings showed strands and nests of epithelioid endothelial cells typical of cutaneous epithelioid hemangioendothelioma. Immunohistochemical stainings confirmed the vascular nature of the tumor. Surgical excision by ear amputation was performed. In a review of the literature, to our knowledge, this clinical presentation as ulceration has never previously been reported.
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