State and territorial regulation of tattooing in the United States.
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Humans↗
Biomedical subjects
W D Tope
Publications and source records attributed to W D Tope.
Merkel cell carcinoma. Histopathology, immunohistochemistry, and cytogenetic analysis.
BACKGROUND: Merkel cell carcinoma (MCC) is a cutaneous neoplasm, histopathologically difficult to differentiate from other small blue cell neoplasms. Immunohistochemical and ultrastructural analyses are usually helpful in differentiating these neoplasms. Recently, cytogenetic analysis has emerged as a potential tool in the diagnosis of solid neoplasms, including MCC. OBJECTIVE: To describe the immunohistochemical and cytogenetic features of a case of primary MCC and to review the cytogenetics literature on MCC. METHODS: Formalin-fixed tissue was processed routinely and labeled with a battery of antibodies. Metaphase cells from fresh tissue were prepared by Giemsa banding. RESULTS: Histopathologically, there were irregular aggregates of pyknotic cells with little cytoplasm. Immunohistochemically, the neoplastic cells stained positive for neurofilament, cytokeratin, neuron-specific enolase, and epithelial membrane antigen. Leucocyte common antigen, S-100, 013, and chromogranin were negative. Karyotyping of neoplastic cells showed loss of chromosome Y (-Y). CONCLUSIONS: Coexpression of cytokeratin and neurofilament is characteristic of MCC and allows it to be differentiated from similar neoplasms. The significance of Y chromosome loss is unclear. Further cytogenetic analyses are warranted to identify genetic mutations significant to the pathogenesis of MCC.
Aged↗
Rhinophyma's fibrous variant. Histopathology and immunohistochemistry.
Rhinophyma may present with either of two distinct histopathologic appearances. The most common shows histopathologic features of rosacea. The second pattern shows telangiectasia, diffuse dermal fibrosis with abundant mucin, and a virtual absence of pilosebaceous structures. These histopathologic features of the lesser-known fibrous variant of rhinophyma mimic those of fibrous papule of the nose. We report an unusual case that histopathologically resembled the second variant. Immunohistochemically, the dermal fibroblasts in this case showed intense staining with Factor XIIIa in a pattern similar to that demonstrated in fibrous papules. S-100 protein failed to stain these dermal fibroblasts. The presence of Factor XIIIa+ dermal fibroblasts may portend the evolution of fibrosis in rosacea and other inflammatory dermatoses.
Aged↗
Neonatal pemphigus vulgaris in a child born to a woman in remission.
We describe the tenth reported case of neonatal pemphigus that mimicked Bart's syndrome and review previously published cases. Unlike previous cases, the child was born with significant blistering to a mother who was in complete remission throughout the pregnancy. High antepartum maternal titers of anti-intercellular space antibodies, increased maternal disease activity, and maternal disease that requires high doses of corticosteroids or use of combined therapy correlate with poor fetal outcome, including intrauterine death.
Adult↗
Cloning and expression of class I major histocompatibility complex genes of the rat.
Little is known about the organization of class I genes in the rat although there is prima facie evidence that it is distinct from that of the mouse. We report the cloning of 61 nonclassical rat class I genes into cosmid clusters with a total mapped length of 1,264 kb. It is certain that the total number of class I genes in the rat must exceed this number. From restriction maps it is possible to identify substantial regions of duplication. By transfection of cosmids into mouse L cells, it has been possible to demonstrate at least seven different nonclassical rat class I genes that are expressible on the cell surface. Crossreaction of a single mouse monoclonal antibody with all of these class I molecules is consistent with sequence homogenization within the rat nonclassical system. Attempts to find rat homologues of the mouse Tla genes by crosshybridization of rat cosmids with a range of different TLa-specific probes were unsuccessful, suggesting that this large group of divergent class I genes is absent or nearly so from the rat. The large number of class I genes in the rat appears to have arisen by expansion of genes more closely related to the classical sequence.
Animals↗
Cutaneous tumor in a child. Cutaneous T-cell lymphoma (CTCL).
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Biopsy↗
Large-cell lymphoma presenting with a distinctive inflammatory dermatosis.
Severe, progressively enlarging inflammatory plaques of the upper trunk and neck developed in a 12-year-old girl. Histologic examination revealed a unique inflammatory cell infiltrate that consisted of chronic inflammation in the dermis subtending spongiosis with a diffuse neutrophilic epidermal infiltrate. A tumor in the right axilla was found by computed tomography. Tissue obtained at open biopsy examination demonstrated a large-cell lymphoma of B-cell origin. The tumor and dermatosis responded dramatically to chemotherapy. The distinctive histologic pattern and clinical course suggest that this dermatosis may represent an unusual paraneoplastic presentation of large-cell lymphoma.
Axilla↗
Positive predictive value for presumptive diagnoses of skin cancer and compliance with follow-up among patients attending a community screening program.
BACKGROUND: There is an ongoing need for evaluating the effectiveness of skin cancer screening programs and barriers to obtaining definitive diagnoses and treatments among screen-positive patients. METHODS: We studied 132 patients who were given presumptive diagnoses of skin cancer while attending a free skin cancer screening program during May 1994 in San Diego, California (464 screened). We assessed compliance with recommendations to see a physician for definitive diagnostic workup. Logistic regression models included potential determinants of compliance: age, gender, health insurance, educational level, anatomic site, number of suspicious skin lesions, personal and family history of skin cancer, propensity to sunburn, and history of recent change in moles. The positive predictive value (PPV) of skin cancer diagnoses was defined conservatively as a range by inclusion then exclusion of patients not biopsied. RESULTS: Follow-up information was obtained for 115 patients, and 88 (77%) of these reported obtaining a definitive workup. The final regression model controlling for age showed that patients without a family history of skin cancer were less compliant than those with a history [OR for noncompliance 3.29, 95% confidence interval (CI) 1.10-9.83], and patients with only one presumptive skin cancer lesion were less compliant than those with additional cancer lesions (OR 5.31, 95% CI 1.07-26.43). Older patients were more compliant than younger. Among 82 patients under 65 years of age, the above factors were important only among men. Also, noncompliance was significantly higher among younger men without versus with health insurance (OR 5.14, 95% CI 1.23-20.68). Two melanomas, 1 squamous cell carcinoma, and 23 basal cell carcinomas were histopathologically confirmed. The PPV for melanoma was 6-15%, for squamous cell carcinoma 4-12%, and for basal cell carcinoma 32-85%. CONCLUSIONS: This study confirms the ability of skin cancer screening programs to successfully identify individuals with cutaneous malignancies. The significant association of noncompliance to seek recommended follow-up care with lack of health insurance for men too young to participate in Medicare suggests that approaches to definitive workup for uninsured patients be developed alongside free screening programs.
Adult↗