Search PubMed⌕ Search

Biomedical subjects

P H Cooper

Publications and source records attributed to P H Cooper.

At least 37 records · Page 2Linked to original sources

Deep penetrating (plexiform spindle cell) nevus. A frequent participant in combined nevus.

This report describes 41 patients with lesions similar to those previously termed "deep penetrating" or "plexiform spindle cell" nevus (DPN). DPN occurs primarily during the first four decades, is somewhat more common in females, and has a predilection for the face, trunk, and proximal extremities. It is usually less than 1 cm in diameter and often shows variegation in color, including shades of brown, blue, and black, that create clinical concern regarding malignant melanoma. None of the present tumors nor those from the literature recurred following excision. Microscopically, DPN usually has a wedge shape, invariably involves reticular dermis, and may penetrate subcutis. Involvement of neurovascular structures and adnexae and spread between fibers of the reticular dermis create a fascicular-plexiform architecture. The melanocytes are fusiform or epithelioid, lightly to moderately pigmented, and exhibit mild to focally prominent nuclear atypia. Sparse to abundant melanophages are characteristic. Mitotic figures are few and present in only a small minority of lesions. The present study of a consecutive series also indicates that DPN is a frequent participant in combined nevus, as it was associated with ordinary nevus in two-thirds of the lesions.

Adolescent↗

Induction of neutrophil-mediated cartilage degradation by interleukin-8.

Neutrophil influx into the inflamed joint is a characteristic feature of disease flares in patients with rheumatoid arthritis. Recently, a protein produced by monocytes and fibroblasts that has chemoattractive/activating properties for neutrophils has been identified and characterized. This protein has been called interleukin-8 (IL-8). In this study, we cocultured neutrophils with 35S-sulfate-labeled cartilage and found that the addition of recombinant human IL-8 (rHuIL-8) caused rapid, neutrophil-mediated cartilage degradation that was the result of induction of neutrophil degranulation by the cytokine. With 10(-7)M rHuIL-8, 23% of the radiolabel was released into the culture medium in 4 hours, compared with a 9% release without the factor. At concentrations of up to 10(-6)M, rHuIL-8 had no direct effect upon cartilage breakdown. These findings indicate that IL-8 may participate in the pathogenesis of rheumatoid arthritis through the induction of neutrophil-mediated cartilage damage.

Animals↗

Lymphoepithelioma-like carcinoma of the skin with adnexal differentiation.

Lymphoepithelioma-like carcinoma of the skin (LELCS) is a recently-described tumor entity with a microscopic resemblance to undifferentiated carcinoma of the nasopharynx. Only five cases of this lesion have been reported heretofore. We document three additional examples of LELCS that were composed of clustered dermal arrays of cytologically malignant, mitotically active polygonal cells, without connections to the overlying epidermis or skin appendages. Chronic inflammatory cells were interspersed throughout each of the tumors. Two of them demonstrated multiple foci of trichilemmal-type keratinization among the neoplastic cells, whereas the other exhibited focal eccrine ductal or glandular differentiation. None of the neoplasms was found to contain nucleic acid of Epstein-Barr virus by in situ hybridization. It is postulated that LELCS represents a primitive cutaneous appendage tumor. Based on the results of a prior publication and those of the current assessment, this neoplasm is thought to have the potential for both sweat glandular and follicular differentiation.

Aged↗

Adenosquamous carcinoma of the skin: a report of 10 cases.

Cutaneous squamous carcinoma with true glandular differentiation has only rarely been documented. Ten patients with such tumors are presented. There were six men and four women, aged 48 to 87 years. The tumors were located on the central face (eight), scalp (one), and hand (one) and consisted of minimally elevated, indurated, keratotic plaques, up to 6 cm in size. Microscopically, the neoplasms exhibited multifocal origin from the epidermis; deep, dispersed, infiltrative growth; perineural invasion; and stromal desmoplasia. Squamous differentiation was most marked superficially. Glandular differentiation was more obvious in deeper areas. Lumens typically developed within squamous nests and were often lined by cells with cytoplasmic vacuoles, some of which contained mucin. The neoplastic cells had obvious cytologic atypia and easily identified mitotic figures. Immunohistochemically, nine neoplasms studied contained carcinoembryonic antigen in glandular foci. Each patient had one or more surgical resections, and six also received radiation and/or chemotherapy. Five patients died with uncontrolled local recurrence, and two are alive with extensive disease and clinical evidence of regional lymph node involvement. Two individuals with small, superficial neoplasms that could be completely removed are disease free. One patient died of unrelated causes shortly after diagnosis. Cutaneous adenosquamous carcinoma is more aggressive than the usual carcinoma of the skin. It must be distinguished from the cytologically bland, microcystic adnexal (sclerosing sweat duct) carcinoma which is capable of recurring but rarely, if ever, proves fatal. The question of whether adenosquamous carcinoma is an epidermally derived squamous tumor with divergent differentiation or should be viewed as a newly recognized adnexal carcinoma remains to be resolved.

Adenocarcinoma↗

Late-onset nevus of Ota.

We report a patient with a type IB nevus of Ota whose lesion did not appear until she was thirty years old. To our knowledge, this represents the oldest age of a patient at clinical onset of nevus of Ota. The diagnosis, implications, and treatment of nevus of Ota are reviewed.

Adult↗

Congenital miliaria crystallina.

Miliaria crystallina is characterized by intracorneal or subcorneal, 1 to 2 mm, clear, noninflammatory vesicles that typically appear in crops after a severe sunburn or during a febrile illness. They frequently occur in neonates, most likely due to lack of maturation of the sweat duct during the first few days following birth, but are rarely present at delivery. We describe here a patient with extensive miliaria crystallina that was present at birth and review possible theories of the pathogenesis of these lesions.

Female↗

Microcystic adnexal carcinoma. An immunohistochemical comparison with other cutaneous appendage tumors.

Since its initial description, microcystic adnexal carcinoma (MAC) of the skin has been controversial. In particular, it features keratin production of the type seen in some pilar neoplasms , and has been thought to pursue partial follicular differentiation. Diagnostically, MAC may be difficult to separate from desmoplastic trichoepithelioma (DTE) in superficial biopsy specimens. We studied 12 MACs, 22 malignant eccrine acrospiromas, 7 sudoriferous syringometaplasias, 6 syringomas, 5 DTEs, and 40 other benign pilar neoplasms immunohistochemically. Paraffin sections and antibodies to "hard" (pilar) keratins. epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), Leu-M1, and S100 protein were employed. The MACs exhibited reactivity for hard keratin subclasses AE 13 and AE 14, EMA, CEA, and Leu-M1. Desmoplastic trichoepitheliomas expressed positivity for AE 14, EMA, and Leu-M1 focally, but lacked the other specified markers. Syringomas and malignant acrospiromas displayed EMA, CEA, and AE 14 reactivity, and 5 syringometaplastic lesions were AE 14-reactive. Benign pilar tumors aside from DTEs were reactive only for AE 13, AE 14, or both. These data indicate that MAC exhibits an immunophenotype that is a "hybrid" of those seen in pure sweat glandular and follicular neoplasms, and suggest that it may indeed show combined pilar and sudoriferous differentiation. Based on these results, it also appears that immunohistochemical analysis may be useful in the diagnostic separation of MAC and DTE.

Adenoma, Sweat Gland↗

Mucinous syringometaplasia with prominent epithelial hyperplasia and deep dermal involvement.

This report describes two patients with mucinous syringometaplasia whose findings expand the microscopic and clinical spectrum of the entity. The first patient had an eroded nodule that exhibited multiple epidermal invaginations that penetrated deeply into the dermis. In addition to mucinous metaplasia, there was also exuberant papillary epithelial hyperplasia. Expanded eccrine ducts with similar changes appeared as lobules isolated in the dermis but were shown to connect with the invaginations. In the second patient, a clinical "cyst" drained serous fluid. Multiple papillary-cystic epithelial lobules similar to those seen in the first case were located in the dermis. A few approached the epidermis, but epidermal connections were not identified. The epithelium in these lesions was identical to that previously described in mucinous syringometaplasia. The tumors differed from prior cases by virtue of the number of eccrine apparatus involved, the extent and depth of involvement, and the presence of prominent papillary epithelial hyperplasia.

Adult↗

"New" neuromas.

Explore the source record for details and available documents.

Humans↗

Papular acne scars. A common cutaneous finding.

One hundred thirty-three patients were examined for the presence of a cutaneous eruption consisting of small, asymptomatic, hypopigmented, follicular papules on the upper part of the trunk. The papules were present in 57% of patients who had a history of acne vulgaris and in 9% of patients who denied ever having had acne. Biopsy specimens from five patients revealed circumscribed, perifollicular or parafollicular lesions in which both elastic and collagen fibers were attenuated in comparison with those in normal adjacent dermis. These changes are consistent with scar. We conclude that the papules are a scarring process secondary to acne vulgaris and propose calling the lesions papular acne scars. They appear closely related to or identical with changes previously termed perifollicular elastolysis, postacne anetoderma-like scars, and papular elastorrhexis.

Acne Vulgaris↗

Benign fibrous histiocytoma of the skin with potential for local recurrence: a tumor to be distinguished from dermatofibroma.

We studied eight patients with benign fibrous histiocytoma (BFH) of the skin that differed, morphologically and biologically, from ordinary dermatofibroma (DF) and compared their tumors with a consecutive series of 141 DF. The patients ranged in age from 13 to 49 yr. Their lesions consisted of cutaneous nodules, 2 cm or less in size, that had been present for less than 1 yr. Seven were located on an extremity. Three of six patients (50%) who could be followed had recurrences 2, 5, and 8 mo following excision of their tumors. Microscopically, seven of the eight cutaneous BFH (CBFH) involved both dermis and subcutis. Five were distinctly multinodular. Subcutaneous involvement and/or multinodularity were present in each case. Fibroblastic and histiocytic cells were arranged in a monotonous storiform pattern throughout most or all of each lesion. There was moderate nuclear variability, but pleomorphism was absent. Several of the tumors contained sparse inflammatory, multinucleate, and foam cells and hemosiderin deposits. Vascularity was prominent. We believe that the multinodular architecture of CBFH and its involvement of both dermis and subcutis usually allow distinction from DF. The latter is uninodular, centered in the dermis, and exhibits only minor subcutaneous extension. Most DF lack the diffuse, well developed storiform appearance of CBFH. Local recurrence further distinguishes CBFH from DF, which rarely recurs. Rather than representing an aberrant form of DF, the clinical and microscopic features of CBFH suggest that it is closely related to, if not identical with, BFH of other tissues and organs.

Adolescent↗

White sponge nevus.

A case is presented of white sponge nevus involving the vaginal, labial, and oral mucosae of a 34-year-old woman. White sponge nevus is a rare, benign, autosomal dominant leukokeratosis that predominantly affects the oral mucosa. Less frequently, it affects extraoral sites including the vulvovaginal mucosa. In this case, histopathologic study of vulvovaginal lesions, subsequent examination of extragenital mucosae, and inquiry into the family history led to the correct diagnosis. The genetics, clinical appearance, and histopathology of white sponge nevus are discussed in relation to the differential diagnosis of oral and vaginal leukokeratoses.

Adult↗

Acral persistent papular mucinosis.

Acral persistent papular mucinosis has recently been proposed as a distinct form of cutaneous mucinosis. We describe a patient and review the literature. We conclude that acral persistent papular mucinosis is a distinct clinical entity, clearly separable from most other forms of cutaneous mucinosis except for one variant of lichen myxedematosus, from which it is less easily distinguished.

Adult↗

Eruptive disseminated lobular capillary hemangioma (pyogenic granuloma).

A 43-year-old man reported a 2-month history of numerous widespread vascular lesions that had developed suddenly on his scalp, trunk, and extremities. The lesions were 2 to 6 mm in diameter, firm, dark red papules that bled easily with minor trauma. Histopathologic examination of four lesions revealed lobular capillary hemangioma, also known as pyogenic granuloma. Treated lesions did not recur after surgical excision or electrocauterization. Five months after the onset of the eruption, no new lesions were developing, and some were resolving spontaneously after bleeding. Eruptive, disseminated lobular capillary hemangioma is a rare, self-limited cutaneous disorder that occurs in otherwise healthy persons.

Adult↗