expression of CXCR3 and cd30 in mycosis fungoides

The clinical progression of mycosis fungoides [MF] often correlates with microscopic large cell transformation [LCT]. It is reported that CD30 expression in the LCT of MF is associated with an absence of CXCR3 expression. This study investigates a large number of patients diagnosed with MF to determine the correlation between expression of CXCR3 and CD30 in additional sections. The study included archival skin specimens from 101 patients with MF. We analyzed these specimens by immunohistochem-istry for expressions of CXCR3 and CD30. The biopsy specimens showed microscopic features of low grade MF [LG-MF] in 80 cases and transformed MF [T-MF] in 21 cases. Tumor lymphocytes expressed CXCR3 in 61 out of 80 cases [76.3%] of LG-MF and in 10 out of 21 cases [47.6%] of T-MF. CD30 positivity [CD30+] was seen in 16 of 80 cases [20%] of LG-MF and 12 of 21 cases [57.1%] of T-MF. The tumor cells in 8 of the 12 CD30+ T-MF cases showed scattered expression of CXCR3. CXCR3 expression was associated with epidermotropic T cell tumors but was greatly absent in dermal ones. Scattered or diffuse CD30 expression in T-MF was not associated with an absence of CXCR3 expression

Description of some dermatoscopic features of acral pigmented lesions in Iranian patients: a preliminary study

Proper differentiation between acral malignant melanoma and benign pigmented lesions like melanocytic nevi is of great value. To avoid unnecessary biopsies, dermatoscopy has been introduced as a non-invasive modality and has improved the clinical diagnostic accuracy in recent decades. We aimed to describe dermoscopic patterns of acral pigmented lesions of patients in the clinic of dermatology in Razi Hospital, Tehran, Iran. This study was conducted as a descriptional study among a total of 62 pigmented lesions located on volar skin of palms and soles. After initial clinical evaluation, lesions were examined entirely by dermoscopy. All the patterns within a lesion were described, and lesions suspicious of malignancy [clinically or dermatoscopically] were selected for histopathological evaluation. Of our 62 lesions, three lesions were not melanocytic. According to our final clinicopathological diagnosis, 47 lesions were benign melanocytic nevi and 12 lesions were malignant melanoma. Parallel furrow pattern was the most frequent among our benign lesions [51.1%] followed by lattice-like pattern [23.4%] and acral reticular pattern [21.3%]. Diffuse multi-component pattern, parallel ridge pattern and abrupt edge were respectively most common patterns among malignant melanomas. Acral benign melanocytic nevi and malignant melanomas respectively have well distinctive characteristics in dermatoscopy among our patients

Consumption of the epidermis in malignant melanoma

Consumption of the epidermis [COE] is defined as thinning of the epidermis with attenuation of the basal and suprabasal layers and loss of rete ridges in areas of direct contact with malignant melanocytes. The aim of this study was to investigate the importance of COE as an additional diagnostic criterion for malignant melanoma and to evaluate its relationship to clinicopathological findings. The age, gender, localization of the lesion and the histopathological parameters such as tumor type, Breslow thickness, ulceration, and Clark's level were recoeded in 90 malignant melanoma cases. In contrast to other studies, we found that COE was more common in tumors with an acral localization and in the acral lentiginous melanoma. Although COE can be used as a pathological criterion in the diagnosis of malignant melanoma, but no correlation no of COE with ulceration and other prognostic factors were found

Microscopic nikolsky's sign: Is it useful for diagnosis of pemphigus vulgaris?

Pemphigus vulgaris [PV] is an autoimmune blistering disease, caused by autoantibodies against desmoglein [Dsg] 3 and/or Dsg 1 which induce the loss of adhesion between keratinocytes. Nikolsky's sign is the ability to induce peripheral extension of a blister as a consequence of applying lateral pressure to the border of on intact blister. If the weakening of the intercellular adhesion is present but not marked, then the damage may be demonstrated only microscopically [microscopic Nikolsky's sign and can increase the sensitivity of the histopathological studies. We studied 40 patients and divided them randomly into two groups [A, B]. Group A were subjected to the tangential pressure over the perilesional skin before a biopsy specimen was taken from that site; group B patients were subjected to a biopsy without the tangential pressure technique. Histopathological changes of pemphigus vulgaris were present in 30% of the patients in group A and 5% of the patients in group B. They were not statistically different. The presence of microscopic Nikolsky's sign was significantly higher in patients with generalized disease. Microscopic Nikolsky sign can increase the sensitivity of histologic diagnosis of PV

Lethal systemic degos disease with prominent cardia-pulmonary involvement

Degos disease DD is a rare obstructive vasculopathy characterized by distinctive skin lesions. Involvement of the soles, palms and genitalia is rare. In most cases, disease has an unfavorable course and involves gastrointestinal tract, central nervous system and occasionally other organs. Pleural and pericardial involvements are usually minor manifestations with prolonged course. Death occurs in approximately 50% of the patients usually due to intestinal perforation or central nervous system bleeding. We describe a 48-year-old man of lethal systemic DD. Widespread skin lesions with involvement of palmoplantar surfaces, genitalia and scalp were ignored for 3 years, whereas the disease revealed own malignant nature. The disorder progressed to nervous, gastrointestinal and cardiopulmonary system that led to death after 5 months from onset of systemic involvement as severe restrictive cardio-pulmonary insufficiency. Autopsy showed diffuse fibrotic changes in serosal membranes and internal organs

[Report of a rare case of bullous mycosis fungoides]

Mycosis fungoides [MF], on extremely rare occasions, can be associated with vesiculobullous eruptions. We describe a 74-year-old man with previous documented histopathologic diagnosis of poikilodermic type of MF who recently developed some flaccid acral bullae on erythemoatous MF plaque and normal skin. Histopathology and direct immunoflourscence studies revealed extensive lichenoid changes with intraepidermal bulla. Atypical lymphocyte infiltration was presented in dermoepidermal junction and bulla fluid and peripheral blood smear, but absent in lymph node and bone narrow tissue specimens. The plausible cause of blister formation in cutaneous lymphoma bullosa may be due to excessive epidermotropism or toxic effects of cytokines secrected by the tumoral infiltrate