Biomedical subjects

L Requena

Publications and source records attributed to L Requena.

At least 19 recordsLinked to original sources

PubMed1992

Acquired symmetric lipomatosis of the soles. A plantar form of the Madelung-Launois-Bensaude syndrome.

Benign symmetric acquired lipomatosis is a rare condition characterized by multiple, diffuse, subcutaneous collections of nonencapsulated mature adipose tissue. A thick and disfiguring deposit of fat is symmetrically distributed in the subcutaneous tissue of the neck, upper trunk and proximal portions of the upper extremities. The face, distal extremities, hands, and feet are characteristically spared. We describe a case in which only plantar involvement was present.

Adipose Tissue↗

PubMed1992

Large-cell acanthoma is a distinctive condition.

We have studied the clinical and histopathologic features of 44 biopsy specimens of large-cell acanthoma (LCA) from 35 patients. There were 19 women and 16 men, 34-88 years of age (mean 75). The lesions were mainly located on the head and extremities, usually solitary, less than or equal to 10 mm in diameter, and of greater than or equal to 1 year's duration. However, there were also cases of multiple and larger lesions, and those of shorter duration. The most frequently offered clinical diagnoses were seborrheic keratosis, Bowen's disease, and LCA; two cases had the clinical features of stucco keratosis. Histologically, 41 of the specimens could be classified into three patterns: 16 lesions showed a basic pattern (mild to moderate acanthosis, hyperkeratosis, large cytoplasms and nuclei, hyperpigmentation, and bulbous rete ridges); 12 specimens showed a verrucous pattern (papillomatosis and hyperkeratosis resembling church spires); and 13 lesions exhibited a flat-hyperkeratotic pattern (compact hyperkeratosis arranged in horizontal layers of corneocytes lying on a band-like acanthotic stratum malpighii that lacks both rete ridges and papillae). Some cases exhibiting this latter pattern showed focal bowenoid changes. Some mixed and intermediate lesions demonstrated the existence of a spectrum. We have concluded that LCA is a distinctive condition with various stages of development and is probably related to stucco keratosis. It can clearly be separated histologically from solar lentigo and from solar keratosis. As other epidermal tumors, LCA can sometimes exhibit features of Bowen's disease.

Adult↗

PubMed1992

Apocrine type of cutaneous mixed tumor with follicular and sebaceous differentiation.

Eight cases of apocrine (tubular branching lumina) type cutaneous mixed tumors with follicular and sebaceous differentiation are presented. All eight tumors arose on facial skin; six patients were male and two were female. The lesions showed a cystic or nodular clinical appearance and were surgically excised. Histopathological examination confirmed the diagnosis of apocrine type of cutaneous mixed tumor in each case. Follicular differentiation consisted of (a) keratinous cysts with infundibular keratinization (infundibular differentiation); (b) hair bulbs with papillary mesenchyma, matricial differentiation with basophilic, transitional, and shadow cells, trichohyaline granules, vellous hair shafts, and clear cells of the outer root sheath (anagen differentiation); and (c) epithelial columns composed of inner cells with plump oval nuclei and scant cytoplasm, and similar cells at the periphery that were arranged in a palisade, resembling the inferior segment of a normal hair follicle in telogen. Sebaceous differentiation was represented by mature sebaceous cells, either as single cells or as small islands, within epithelial tracts of the tumor. The proportion of the areas showing these different types of differentiation varied among lesions, but some follicular differentiation was always present, whereas three cases lacked sebaceous differentiation. Immunohistochemical analysis in three cases with respect to their eccrine or apocrine differentiation showed contradictory results as in a previously reported series of cutaneous mixed tumors. The presence of follicular and sebaceous differentiation in the apocrine (tubular branching lumina) type of cutaneous mixed tumor is a confirmation of the apocrine nature of this neoplasm as well as an expression of the common embryologic derivation of all elements of the folliculosebaceous-apocrine unit.

Adenoma, Sweat Gland↗

PubMed1992

Complex adnexal tumor of the primary epithelial germ with distinct patterns of superficial epithelioma with sebaceous differentiation, immature trichoepithelioma, and apocrine adenocarcinoma.

A 60-year-old man came for treatment of a sharply outlined erythematous plaque on the gluteal area (45 x 20 mm) of 20 years' duration. Eccentrically located on the plaque was a nodule, 20 mm in diameter. Histological study of the plaque showed a superficial platelike tumor with basaloid bland cytology and sebaceous gland differentiation. Histologic study of the nodule found an undifferentiated adenocarcinoma whose ductlike glandular structures opened to the skin surface and infiltrated the whole depth of the dermis. Study of other areas of the lesion detected two more neoplasms. A nodule of squamous cell carcinoma was found within the superficial band of the benign sebaceous tumor. The fourth neoplastic pattern consisted of epithelial islands composed of basaloid cells within a fibroblastic stroma. There was prominent palisading of epithelial cell nuclei at the periphery of the islands, which usually were surrounded by a sheath of mesenchymal cells. In this complex adnexal tumor of the primary epithelial germ, sebaceous and follicular differentiation both simulate neoplastic patterns recently described as separate entities: superficial epithelioma with sebaceous differentiation and immature trichoepithelioma. The undifferentiated adenocarcinoma may represent differentiation toward the third component of the germ, that is, the apocrine gland.

Adenocarcinoma↗

PubMed1992

Basal cell carcinoma with matrical differentiation.

Three cases of basal cell carcinoma showing shadow cells within basaloid islands have been described using the term basal cell carcinoma with matrical differentiation for this histologic variant. We present four new cases of basal cell carcinoma with evidence of matrical differentiation. Unlike the cases previously published, these lesions showed nests of shadow cells either within the lobules of basaloid cells or forming nests in the stroma. We also noted the presence of a foreign body reaction and calcification. These neoplasms illustrate the capability of basal cell carcinoma to differentiate toward hair matrix cells. Basal cell carcinoma with matrical differentiation must be added to the uncommon variants of basal cell carcinoma showing adnexal differentiation. A parallel between the degrees of differentiation of the cutaneous sebaceous neoplasms with those showing matrical differentiation is proposed.

Aged↗

PubMed1992

Cutaneous lymphadenoma with ductal differentiation.

Cutaneous lymphadenoma (CL) is a recently described neoplasm of unknown histogenesis. Histologically, these tumors typically present as well-circumscribed nodules with scant or no epidermal connections. They are composed of multiple rounded lobules of basaloid cells with some degree of peripheral palisading. These epithelial lobules characteristically show a dense lymphoid infiltrate within them. In cases of CL previously described, there was no obvious adnexal differentiation except for isolated cells showing apparent sebaceous differentiation or hints of follicular differentiation. We report two typical cases of CL that were studied histologically and immunohistochemically. In some of the tumor lobules, there were foci of ductal differentiation, with luminal positivity for CEA and EMA. We postulate that some CL represent a form of immature sweat gland tumor with ductal differentiation.

Adult↗

PubMed1992

Multiple sclerotic fibromas of the skin. A cutaneous marker of Cowden's disease.

Multiple hamartoma syndrome, or Cowden's disease, is a rare genodermatosis with multiple organ system involvement in which malignancy, particularly of breast and thyroid, may develop. Multiple trichilemmomas have been classically regarded as the cutaneous hallmark of this disease. We here emphasize multiple sclerotic fibromas of the skin as another specific cutaneous marker of this entity, which may also be helpful in an early diagnosis.

Adult↗

PubMed1992

Plate-like sebaceous hyperplasia overlying dermatofibroma.

Epidermal hyperplasia, sometimes with primitive hair follicle-like differentiation, is a characteristic finding overlying dermatofibroma. We here report plate-like sebaceous hyperplasia overlying a dermatofibroma. Such changes are interpreted as a result of inductive epithelial effect by the dermatofibroma on the overlying epidermis.

Adult↗

PubMed1992

Poroid hidradenoma: a light microscopic and immunohistochemical study.

Poroid hidradenoma is a recently described variant of the eccrine poroma group of tumors. This neoplasm shows architectural characteristics of hidradenoma (tumor cells confined entirely within the dermis in both solid and cystic components) and cytologic characteristics of poroid neoplasm (poroid and cuticular cells, the latter showing ductal differentiation). Therefore the term "poroid hidradenoma" seems to be the most appropriate. We document herein a case of poroid hidradenoma studied by immunoperoxidase techniques. Our immunohistochemical results are similar to those of other poroid neoplasms. These also support the inclusion of this tumor as the fourth variant within the eccrine poroma group of tumors.

Adenoma, Sweat Gland↗

PubMed1992

Multiple epidermoid cysts in a renal transplant recipient taking cyclosporine A.

A forty-two-year-old male recipient of a cadaver renal transplant showed multiple nodulocystic lesions on his back and lateral aspects of his neck four months after beginning immunosuppressive therapy with cyclosporine A and prednisone. Results of histopathologic studies revealed that they were epidermoid infundibular cysts. We note the relationship between this clinical appearance and cyclosporine A, as well as this agent's cutaneous side effects.

Adult↗

PubMed1992

Erythrodermic mastocytosis.

Erythrodermic mastocytosis is a rare variant of diffuse cutaneous mastocytosis in which the skin becomes red, thickened, and lichenified and has a doughy consistency with multiple small papules on its surface, giving a leathery appearance to the skin. In this report, I describe a curious case of erythrodermic mastocytosis that appears to be due to vasodilation rather than to mast cell infiltration of the skin. In my opinion, this case might be an example of generalized telangiectasia macularis eruptiva perstans. Results of all laboratory tests failed to demonstrate systemic mast cell involvement; therapy with a combination of H1 and H2 antihistamines plus disodium cromoglycate controlled the symptoms.

Adult↗

PubMed1991

Malignant combined nevus.

This report describes an example of combined nevus with malignant transformation. The clinical impression was blue nevus. Histologically, the lesion was composed of a cellular blue nevus in the reticular dermis and an overlying compound melanocytic nevus. The junctional component of the melanocytic nevus showed transition to malignant melanoma in situ. A review of the literature failed to find a precedent for the present case.

Cell Nucleus↗

PubMed1991

Follicular hybrid cysts. An expanded spectrum.

Currently it is well established that each of the three parts of the hair follicle (infundibulum, isthmus, and the inferior portion) originates different types of cutaneous cysts. Thus, follicular cysts include infundibular, trichilemmal, and matricial cysts. Brownstein in 1983 described a mixed type of cutaneous cyst combining epidermoid, infundibular, and trichilemmal types of keratinization. We review and illustrate the different combinations of follicular hybrid cysts reported to date: infundibular and trichilemmal cyst, infundibular and pilomatricoma cyst, trichilemmal and pilomatricoma cyst, eruptive vellus hair cyst and steatocystoma, and eruptive vellus hair cyst and trichilemmal cyst. Therefore, the concept of hybrid cyst should not be restricted to those composed of infundibular and trichilemmal cysts, because any cyst arising from the various parts of the pilosebaceous unit can combine with others to form a large series of follicular hybrid cysts.

Diagnosis, Differential↗

PubMed1991

Epidermotropic metastases from internal carcinomas.

Four cases of epidermotropically metastatic carcinoma are reported. One of them originated from a breast adenocarcinoma; in two other cases, the primary tumor was located in the large intestine; and, in the fourth case, the primary malignancy was a laryngeal squamous cell carcinoma. Clinically, the cutaneous metastases were nodular lesions and histologically, in addition to the involvement of the dermis by malignant cells, in three cases there was intraepidermal involvement by glandular structures. In the fourth case, the cutaneous metastatic tumor cells showed striking "folliculotropism." We review the literature of epidermotropically metastatic carcinoma and discuss its differential diagnosis.

Aged↗

PubMed1991

Multiple trichodiscomas: histogenetical observations.

A 23-year-old man with multiple trichodiscomas on his face is described. Four papules were histologically examinated, and all of them showed similar findings, a dermal fibrovascular proliferation with abundant ground substance between collagen bundles and an absence of elastic fibers. We found no evidence to establish a relationship between trichodiscomas and hair disk, and, in our opinion, these lesions should be included into the spectrum of hyperplasia of the adventicial dermis.

Adult↗

PubMed1991

Erythema elevatum diutinum mimicking porphyria cutanea tarda.

A case of erythema elevatum diutinum (EED) closely resembling porphyria cutanea tarda (PCT) is reported. The initial skin biopsies were suggestive for PCT but porphyrin levels in the urine, stool and plasma were normal. A further biopsy from an early cutaneous lesion showed a leucocytoclastic vasculitis with fibrinoid necrosis of the vessel walls.

Adult↗

PubMed1991

Hereditary epidermolytic palmo-plantar keratoderma (Vörner type)--report of a family and review of the literature.

We describe a patient in whose family 13 of 26 members have a palmo-plantar keratoderma. The histopathological findings in the proband, his brother and father were those of epidermolytic hyperkeratosis. As in other families reported, this disorder was found to be inherited as an autosomal-dominant trait. A review of the literature on the clinical, genetic and associated features of this genodermatosis is presented. We also review the cutaneous conditions that may exhibit the histopathological pattern of epidermolytic hyperkeratosis.

Adult↗

PubMed1991

An unusual benign neural tumour with stellate-cell morphology.

We report a stellate-cell dermal tumour which was studied by immunohistochemistry and electron microscopy. The stellate morphology of the tumour cells appeared to be due to retraction of their cytoplasm resulting in the emergence of intercellular spaces. Results of the immunohistochemical investigations were consistent with a neural tumour, but we could not assign it to any particular category of the known neural tumours. Therefore we have designated this tumour as an unusual, benign, neural-tumour with stellate-cell morphology.

Female↗