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Epidermal Hyperplasia (epidermal + hyperplasia)
Selected AbstractsTopical treatment with thiazolidinediones, activators of peroxisome proliferator-activated receptor-,, normalizes epidermal homeostasis in a murine hyperproliferative disease modelEXPERIMENTAL DERMATOLOGY, Issue 3 2006Marianne Demerjian Abstract:, In a murine model of epidermal hyperplasia reproducing some of the abnormalities of several common skin disorders, we previously demonstrated the antiproliferative and pro-differentiating effects of peroxisome proliferator-activated receptor (PPAR),, PPAR,/,, and liver X receptor activators. Unlike other subgroups of PPAR activators, thiazolidinediones (TZDs), a family of PPAR, ligands, did not inhibit keratinocyte proliferation in normal murine skin. Here, we studied the effects of two TZDs, namely ciglitazone (10 mM) and troglitazone (1 mM), in the same murine model where epidermal hyperproliferation was reproduced by repeated barrier abrogation with tape stripping. Topical treatment with ciglitazone and troglitazone resulted in a marked and significant decrease in epidermal thickness. Furthermore, in all TZD-treated groups, we observed a significant decrease in keratinocyte proliferation using proliferating cell nuclear antigen, 5-bromo-2,-deoxyuridine, and tritiated thymidine incorporation. However, using the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay, we found no difference in apoptosis between different treatments, emphasizing that it is the antiproliferative role of these activators that accounts for the decrease of epidermal thickness. Finally, using immunohistochemical methods, we determined the effects of ciglitazone on keratinocyte differentiation in this hyperproliferative model. We observed an increased expression of involucrin and filaggrin following ciglitazone treatment, suggesting a pro-differentiating action of TZDs in this model. In summary, topical TZDs significantly reduce epidermal keratinocyte proliferation while promoting differentiation in a murine model of hyperproliferative epidermis. Together, these results suggest that in addition to their metabolic effects currently in use in the treatment of type 2 diabetes, topical TZDs could be considered as potential alternative therapeutic agents in hyperproliferative skin diseases such as psoriasis. [source] Eccrine squamous syringometaplasia mimicking a herpetic infectionINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2006Vicent Alonso MD A 69-year-old woman with a history of hypertension and essential tremor was diagnosed with a Burkitt-like diffuse large-cell lymphoma. She received chemotherapy with cyclophosphamide, vincristine and adriamycin (HyperCVAD). Ten days after starting the second cycle of chemotherapy (HyperCVAD), she presented with well-defined, intense, erythematous macules which coalesced to form a symmetric diffuse erythema located on the upper back. Later, the lesions progressed and affected the lower back and perineal areas, extending to the groin. In a few days, a gradual diminution of the erythema was seen, with subsequent development of postinflammatory gray-brownish hyperpigmentation. On the lower back, there were also superficial erosions. Some asymptomatic, closely grouped, gray papules, vesicles, and blisters were found in the groin, resembling the typical lesions of herpetic infection (Fig. 1). Two biopsies of the groin and one of the upper back were performed, and were processed for histopathologic and microbiologic study. Figure 1. Closely grouped gray papules, vesicles, and blisters on the groin mimicking a herpetic infection The histopathologic study showed epidermal hyperplasia with acanthosis and papillomatosis. In both biopsies, eccrine ducts covered by mature squamous epithelium were found in the reticular dermis (Fig. 2a,c). In the sample from the groin, an intracorneal bulla was found. Numerous normal isolated cornified cells were seen within the lumen of the bulla (Fig. 2d). An inflammatory mononuclear infiltrate was also present in a periductal and perivascular distribution. No multinucleation, ground-glass nuclei, or peripheral margination of chromatin were found. Therefore, no morphologic evidence of herpes virus infection was present. Figure 2. Low (a), medium (b), and high (c) magnification showing epidermal hyperplasia and squamous syringometaplasia involving dermal eccrine ducts. (d) Medium power magnification of the intracorneal bulla (hematoxylin and eosin staining; a, ×40; b, ×100; c, ×400; d, ×100) Cultures and serologic analyses for herpes simplex virus (HSV) 1 and 2, varicella zoster virus (VZV), and cytomegalovirus (CMV) were negative. The lesions were treated with topical corticosteroids, with a good response in a few days. [source] Prurigo nodularis: systematic analysis of 58 histological criteria in 136 patientsJOURNAL OF CUTANEOUS PATHOLOGY, Issue 5 2010Nils Weigelt Background: To date, there has been no systematic investigation of the detailed histological features of prurigo nodularis (PN) in a large cohort of patients. Methods: This retrospective study includes skin biopsies of 136 patients (63 males, 73 females; mean age: 58.38 years) with PN. Results: Highly characteristic for PN is the presence of thick compact orthohyperkeratosis; the hairy palm sign (folliculosebaceous units in nonvolar skin in conjunction with a thick and compact cornified layer, like that of volar skin); irregular epidermal hyperplasia or pseudoepitheliomatous hyperplasia; focal parakeratosis; hypergranulosis; fibrosis of the papillary dermis with vertically arranged collagen fibers; increased number of fibroblasts and capillaries; a superficial, perivascular and/or interstitial inflammatory infiltrate of lymphocytes, macrophages and, to a lesser extent, eosinophils and neutrophils. For comparison, histological findings in 45 patients (18 males, 27 females; mean, 55.64 years) with lichen simplex (LS) were studied. PN and LS, both of them scratch-induced, had 50 of 58 (86.2%) histological features in common. Conclusions: PN revealed a characteristic histological pattern. Absence of pseudoepitheliomatous hyperplasia or nerve fiber thickening, however, does not rule out the histological diagnosis of PN. A correlation of clinical and histological findings is necessary to reliably distinguish between PN and LS. Weigelt N, Metze D, Ständer S. Prurigo nodularis: systematic analysis of 58 histological criteria in 136 patients. [source] Superficial leiomyosarcoma: a clinicopathologic review and updateJOURNAL OF CUTANEOUS PATHOLOGY, Issue 2 2010Clarissa T. Fauth Fauth CT, Bruecks AK, Temple W, Arlette JP, DiFrancesco LM. Superficial leiomyosarcoma: a clinicopathologic review and update. Background: Superficial leiomyosarcomas (SLMSs) are rare soft tissue malignancies. A clinicopathologic review of 25 cases was undertaken. Methods: Twenty-five cases diagnosed between 1990 and 2007 were reviewed. Clinical information was obtained from patient charts. Histologic slides were reviewed, and immunohistochemical stains were performed. Results: All patients presented with a nodule. Fourteen tumors were confined to the dermis and 11 involved subcutaneous tissue. Smooth muscle markers were positive in all cases. CD117 was consistently negative. Novel histological features included epidermal hyperplasia, sclerotic collagen bands and increasing tumor grade with the depth of the lesion. Poor outcome was associated with size > 2 cm, high grade and depth of the lesion. Conclusions: SLMSs are rare but important smooth muscle tumors of the skin. The clinical presentation may be non-specific. The histologic appearance is that of a smooth muscle lesion, but epidermal hyperplasia and thickened collagen bands are previously underrecognized features. Immunohistochemical stains are useful in confirming smooth muscle differentiation, but CD117 is of limited utility. SLMS can appear low grade or even benign on superficial biopsies, leading to undergrading or a delay in the correct diagnosis. Clinicians and pathologists alike should therefore be aware of these pitfalls and must approach these cases with caution. [source] Localized lymphedema (elephantiasis): a case series and review of the literatureJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2009Song Lu Background:, Lymphedema typically affects a whole limb. Rarely, lymphedema can present as a circumscribed plaque or an isolated skin tumor. Objective:, To describe the clinical and pathologic characteristics and etiologic factors of localized lymphedema. Methods:, Case,control study of skin biopsy and excision specimens histologically diagnosed with lymphedema and presenting as a localized skin tumor identified during a 4-year period. Results:, We identified 24 cases of localized lymphedema presenting as solitary large polyps (11), solid or papillomatous plaques (7), pendulous swellings (4), or tumors mimicking sarcoma (2). Patients were 18 females and 6 males with a mean age of 41 years (range 16,74). Anogenital involvement was most frequent (75%) , mostly vulva (58%), followed by eyelid (13%), thigh (8%) and breast (4%). Causative factors included injury due to trauma, surgery or childbirth (54%), chronic inflammatory disease (rosacea, Crohn's disease) (8%), and bacterial cellulitis (12%). Eighty-five percent of these patients were either overweight (50%) or obese (35%). Compared with a series of 80 patients with diffuse lymphedema, localized lymphedema patients were significantly younger (41 vs. 62 years old, p = 0.0001), had no history of cancer treatment (0% vs. 18%, p = 0.03), and had an injury to the affected site (54% vs. 6%, p = 0.0001). Histologically, all cases exhibited dermal edema, fibroplasia, dilated lymphatic vessels, uniformly distributed stromal cells and varying degrees of papillated epidermal hyperplasia, inflammatory infiltrates and hyperkeratosis. Tumor size significantly and positively correlated with history of cellulitis, obesity, dense inflammatory infiltrates containing abundant plasma cells, and lymphoid follicles (p < 0.05). A history of cellulitis, morbid obesity, lymphoid follicles and follicular cysts predicted recurrent or progressive swelling despite excision (p < 0.05). Conclusions:, Localized lymphedema should be considered in the etiology of skin tumors when assessing a polyp, plaque, swelling or mass showing dermal edema, fibrosis and dilated lymphatics on biopsy. A combination of lymph stasis promoting factors (trauma, obesity, infection and/or inflammatory disorders) produces localized elephantiasis. [source] Activation of Src-family tyrosine kinases in hyperproliferative epidermal disordersJOURNAL OF CUTANEOUS PATHOLOGY, Issue 3 2008Elias E. Ayli Background:, Src-family tyrosine kinases (SFKs) are important regulators of keratinocyte growth and differentiation. In a broad range of cell types, persistent activation of SFKs correlates with increased cell proliferation. In this study, we determined if SFK activity is increased in cutaneous neoplasia and psoriasis, common hyperproliferative epidermal disorders. Methods:, Formalin-fixed tissue sections of unremarkable epidermis, psoriasis, actinic keratoses (AKs), squamous cell carcinoma in situ (SCIS) and squamous cell carcinoma (SCC) were subjected to immunohistochemical staining for activated SFKs. Results:, All psoriasis specimens displayed significantly greater staining for activated SFKs than sections of unremarkable skin. In the psoriasis biopsies, the degree of epidermal hyperplasia was proportional to the level of activated SFK staining. All AKs, SCISs and SCCs exhibited more prominent staining than sections of unremarkable epidermis. No discernable difference in activated SFK staining was seen between AKs, SCIS and SCC specimens. Conclusions:, This study shows increased staining of activated SFKs in human biopsy specimens of psoriasis and cutaneous neoplasia. These data provide direct evidence for increased activation of SFKs in the pathogenesis of hyperproliferative epidermal disorders. [source] Non-pustular palmoplantar psoriasis: is histologic differentiation from eczematous dermatitis possible?JOURNAL OF CUTANEOUS PATHOLOGY, Issue 2 2008Ovgu Aydin Both palmoplantar psoriasis and eczematous dermatitis of this skin area share similar histologic features. The punch biopsies from 17 patients with psoriasis and 25 with eczematous dermatitis were evaluated, blind to the clinical diagnosis. Vertically situated multiple foci of parakeratosis, alternating with orthokeratosis, were the only statistically significant feature in the differential diagnosis of palmoplantar psoriasis [76.5% (13/17), p = 0.005]. In contrast, multiple foci of parakeratosis [70.6% (12/17)], loss of granular layer at least in focal areas [41.2% (7/17)], presence of neutrophils at the summits of parakeratosis [4% (1/17)], presence of neutrophils and/or plasma in the parakeratotoic foci [94.1% (16/17) and 11.8% (2/17)], psoriasiform epidermal hyperplasia [88.2% (15/17)], spongiosis restricted to the lower parts of the epidermis [47.1% (8/17)], dyskeratotic cells [82.4% (14/17)], thinning of suprapapillary plate [58.8% (10/17)], edema of the papillary dermis [29.4% (5/17)], presence of tortous and dilated capillaries in the papillary dermis [52.9% (9/17) and 76.5% (13/17)] and extravasated erythrocytes [29.4% (5/17)] were found to be more common in palmoplantar psoriasis compared with eczematous dermatitis; but none of them was statistically significant. Interestingly, spongiotic vesicles were seen in most of the patients with psoriasis [76.5% (13/17)]. In conclusion, according to our findings, many features of palmoplantar psoriasis overlapped with those of eczematous dermatitis. However, detection of multiple parakeratotic foci, placed vertically, alternating with orthohyperkeratosis, could be considered in favor of palmoplantar psoriasis. [source] Fibroepithelioma-like changes occurring in perianal Paget's disease with rectal mucinous carcinoma: case report and review of 49 cases of extramammary Paget's diseaseJOURNAL OF CUTANEOUS PATHOLOGY, Issue 3 2002Akemi Ishida-Yamamoto Background:, Anogenital Paget's disease (PD) may be accompanied by varying degrees of epidermal hyperplasia. The histological changes can be reminiscent of fibroepithelioma of Pinkus. Methods:, We present a case of perianal PD associated with fibroepitheliomatous epidermal hyperplasia in a 76-year-old-man with an underlying rectal mucinous carcinoma. We also carried out a retrospective analysis of 51 biopsies from 49 cases of extramammary PD to see whether particular epidermal changes occur in association with PD in different anatomic locations. Results:, A tumor, 3 cm in diameter, was noted in the patient's perianal skin. Histologically, it was composed of anastomosing thin epithelial strands with follicular differentiation. Paget's cells were distributed in the epithelial strands of this tumor as well as in the surrounding epidermis and anal epithelia. In our series of extramammary PD, epidermis was hyperplastic in two of two perianal cases, 26 of 43 genital skin samples, and one of six axillary PD biopsies. The stroma beneath the hyperplastic epidermis tended to be rich in thin collagen fibers and fibroblasts. Conclusions:, Anogenital PD was more frequently associated with epidermal hyperplasia than axillary PD. Fibroepitheliomatous hyperplasia may be induced by the altered stroma associated with PD. [source] Creation of psoriatic plaques: the ultimate tumor suppressor pathway.JOURNAL OF CUTANEOUS PATHOLOGY, Issue 2 2001A new model for an ancient T-cell-mediated skin disease. From an oncological and immunological perspective, the T-cell-mediated induction of psoriatic plaques should be prone to malignant transformation as the phenotype of psoriatic plaques includes: chronic inflammation, epidermal hyperplasia, prolonged survival and elevated telomerase levels in lesional keratinocytes, as well as angiogenesis, exposure to carcinogens and immunosuppressants. However, conversion of a psoriatic plaque to squamous cell carcinoma is exceedingly rare. This paper explores the possible molecular mechanism for the tumor suppressor pathway in psoriatic lesions, with an emphasis on a putative senescence-switch involving p16. [source] Skin problems in lower limb amputees: an overview by case reportsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2007HEJ Meulenbelt Abstract The stump in lower limb amputees is prone to skin problems because it is exposed to several unnatural conditions (shear and stress forces and increased humidity) when a prosthesis is used. This study reviews the literature on case reports of lower limb amputees with skin problems on the stump. In total, 56 reports comprising 76 cases were identified in the literature. The main disorders are acroangiodermatitis, allergic contact dermatitis, bullous diseases, epidermal hyperplasia, hyperhidrosis, infections, malignancies and ulcerations. [source] Differential requirements for interleukin (IL)-4 and IL-13 in protein contact dermatitis induced by AnisakisALLERGY, Issue 9 2009N. Nieuwenhuizen Background:, Exposure to antigens of the fish parasite Anisakis is associated with the development of protein contact dermatitis in seafood-processing workers. Understanding the basic mechanisms controlling allergic sensitization through the skin is critical for designing therapies that will prevent the progression of allergic disease. Objective:, To investigate the roles of interleukin (IL)-4, IL-13 and the IL-4R, in both local skin pathology and systemic sensitization following epicutaneous exposure to Anisakis proteins. Methods:, BALB/c wild-type (WT) mice and mice deficient in IL-4, IL-13 or IL-4 and IL-13, as well as mice with cell-specific impairment of IL-4R, expression, were sensitized to Anisakis antigen by repeated epicutaneous application of Anisakis extract. Following this sensitization, skin pathology was recorded and systemic responses were investigated. Intravenous challenge with Anisakis extract was performed to test for the development of biologically relevant systemic sensitization. Results:, In WT mice, epicutaneous sensitization with Anisakis larval antigens induced localized inflammation, epidermal hyperplasia, production of TH2 cytokines, antigen-specific IgE and IgG1. Intravenous challenge of sensitized mice resulted in anaphylactic shock. Interestingly, IL-13 deficient mice failed to develop epidermal hyperplasia and inflammation, whilst anaphylaxis was reduced only in strains deficient either in IL-4 only, or deficient in IL-4 and IL-13 concurrently, as well as in mice deficient in IL-4R, or with impaired IL-4R, expression on CD4+ T cells. Conclusions:, Interleukin-13 plays a central role in protein contact dermatitis associated with repeated epicutaneous exposure to Anisakis extract, whereas IL-4 drives systemic sensitization and resultant anaphylactic shock. [source] Cyclooxygenase-2 deficiency increases epidermal apoptosis and impairs recovery following acute UVB exposureMOLECULAR CARCINOGENESIS, Issue 5 2007Jacqueline K. Akunda Abstract The cyclooxygenases, COX-1 and COX-2, are involved in cutaneous responses to both acute and chronic UV exposure. In the present study, wild-type (WT), COX-1,/, and COX-2,/, mice were used to determine the influence of the individual isoform on mouse skin responses to acute UVB treatment. Immunohistochemistry and Western analysis indicated that COX-2, and not COX-1, was induced by UVB (2.5 or 5.0 kJ/m2), but that COX-1 remained the major source of prostaglandin E2 production. UVB exposure significantly increased epidermal apoptosis in all genotypes compared to untreated mice. However, while the number of apoptotic cells in WT and COX-1,/, mice were about equal, the number of apoptotic cells was 2.5-fold greater in COX-2,/, mice. Apoptosis in WT and COX-2,/, mice peaked at 24 h post-exposure. The increased apoptosis and reduced proliferation in COX-2,/, mice resulted in about a 50% decrease in epidermal thickness at 24,48 h post-exposure compared to about a 50% increase in epidermal thickness in WT mice. UVB-induced cell replication, as measured by BrdU labeling, was reduced in COX-2,/, compared to WT mice at 24,96 h. However, by 96 h post-exposure, both WT and COX-2,/, mice showed epidermal hyperplasia. The data indicate that COX-2 induction initially protects against the acute sunburn effects of UVB, but that continuous induction of COX-2 may contribute to skin cancer in chronic UVB exposure. © 2007 Wiley-Liss, Inc. [source] Psoriasis vs allergic contact dermatitis in palms and soles: a quantitative histologic and immunohistochemical studyAPMIS, Issue 8 2009ANNA MARIA CESINARO Cesinaro AM, Nannini N, Migaldi M, Pepe P, Maiorana A. Psoriasis vs allergic contact dermatitis in palms and soles: a quantitative histologic and immunohistochemical study. APMIS 2009; 117: 629,34. A systematic histologic and immunohistochemical study of cases of psoriasis (PSO) and allergic contact dermatitis (ACD) in palmo-plantar skin was performed to find differences between these two diseases that usually show overlapping features in these specific sites. Skin biopsies from 42 (22 female, 20 male) patients were evaluated for several histopathologic parameters and immunohistochemistry was applied to quantify keratinocytic proliferation, the number of dendritic cells (DCs) and the phenotype of the mononuclear cell infiltrate. Regular epidermal hyperplasia and marked parakeratosis were found to be more frequent in PSO than in ACD cases, but only the first parameter reached the level of significance (p = 0.03). The number of S100 protein-positive DCs was significantly higher in ACD (p = 0.006), whereas keratinocytic proliferation, studied with Mib-1, was found to be higher in PSO than in ACD, but the difference was not statistically significant. No significant difference was detected in the number of CD4+, CD8+ and bcl2+ lymphocytes in PSO and ACD cases. In the palms and soles, the finding of irregular epidermal hyperplasia and the detection of a higher number of S100 protein-positive DCs favor the diagnosis of ACD over PSO. The differential diagnosis between PSO and ACD can be practically approached using a histopathologic parameter and a commercially available antibody. [source] | ||||||||||