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1.
Carcinogenesis ; 40(11): 1363-1375, 2019 11 25.
Article in English | MEDLINE | ID: mdl-30820526

ABSTRACT

XB130 is an adaptor protein that functions as a mediator of multiple tyrosine kinases important for regulating cell proliferation, survival, migration and invasion. Formerly predicted as an oncogene, alterations of its expression are documented in various human cancers. However, the exact role of XB130 in tumorigenesis is unknown. To address its function in skin tumorigenesis, a two-stage dimethylbenzanthracene (DMBA)/12-O-tetradecanoylphorbol 13-acetate (TPA) study was performed on XB130 knockout (KO), heterozygous (HZ) and wild-type (WT) littermate mice. DMBA/TPA-treated XB130 KO and HZ males developed a significantly higher number of epidermal tumors that were notably larger in size than did WT mice. Interestingly, DMBA/TPA-treated female mice did not show any difference in tumor multiplicity regardless of the genotypes. The skin tumor lesions of XB130 KO males were more progressed with an increased frequency of keratoacanthoma. Deficiency of XB130 dramatically increased epidermal tumor cell proliferation. The responses to DMBA and TPA stimuli were also individually investigated to elucidate the mechanistic role of XB130 at different stages of tumorigenesis. DMBA-treated male XB130 KO mice showed compensatory p53-mediated stress response. TPA-treated XB130 KO males demonstrated more skin ulceration with more severe edema, enhanced cell proliferation, accumulation of infiltrating neutrophils and increased production of pro-inflammatory cytokine genes compared with WT mice. Enhanced activities of nuclear factor-kappa B pathway, increased protein expression of metalloproteinase-9 and ERK1/2 phosphorylation were found in these KO mice. These findings demonstrate that XB130 acts as a tumor suppressor in carcinogen-induced skin tumorigenesis that may be mediated through inhibiting inflammation.


Subject(s)
Adaptor Proteins, Signal Transducing/metabolism , Carcinogenesis , Genes, Tumor Suppressor , Inflammation , Microfilament Proteins/metabolism , Skin Neoplasms/metabolism , 9,10-Dimethyl-1,2-benzanthracene/toxicity , Adaptor Proteins, Signal Transducing/genetics , Animals , Carcinogens/toxicity , Cell Proliferation , Female , Male , Mice , Mice, Knockout , Microfilament Proteins/genetics , Skin Neoplasms/etiology , Skin Neoplasms/genetics , Skin Neoplasms/physiopathology , Tetradecanoylphorbol Acetate/toxicity
2.
Cancer Immunol Immunother ; 68(5): 773-785, 2019 May.
Article in English | MEDLINE | ID: mdl-30747243

ABSTRACT

Adoptive cell therapy using autologous tumor-infiltrating lymphocytes (TIL) has shown significant clinical benefit, but is limited by toxicities due to a requirement for post-infusion interleukin-2 (IL-2), for which high dose is standard. To assess a modified TIL protocol using lower dose IL-2, we performed a single institution phase II protocol in unresectable, metastatic melanoma. The primary endpoint was response rate. Secondary endpoints were safety and assessment of immune correlates following TIL infusion. Twelve metastatic melanoma patients were treated with non-myeloablative lymphodepleting chemotherapy, TIL, and low-dose subcutaneous IL-2 (125,000 IU/kg/day, maximum 9-10 doses over 2 weeks). All but one patient had previously progressed after treatment with immune checkpoint inhibitors. No unexpected adverse events were observed, and patients received an average of 6.8 doses of IL-2. By RECIST v1.1, two patients experienced a partial response, one patient had an unconfirmed partial response, and six had stable disease. Biomarker assessment confirmed an increase in IL-15 levels following lymphodepleting chemotherapy as expected and a lack of peripheral regulatory T-cell expansion following protocol treatment. Interrogation of the TIL infusion product and monitoring of the peripheral blood following infusion suggested engraftment of TIL. In one responding patient, a population of T cells expressing a T-cell receptor Vß chain that was dominant in the infusion product was present at a high percentage in peripheral blood more than 2 years after TIL infusion. This study shows that this protocol of low-dose IL-2 following adoptive cell transfer of TIL is feasible and clinically active. (ClinicalTrials.gov identifier NCT01883323.).


Subject(s)
Immunotherapy, Adoptive/methods , Interleukin-2/therapeutic use , Lymphocytes, Tumor-Infiltrating/immunology , Melanoma/therapy , Skin Neoplasms/therapy , Adult , Cell Proliferation , Cells, Cultured , Female , Humans , Interleukin-15/metabolism , Lymphocytes, Tumor-Infiltrating/transplantation , Male , Melanoma/immunology , Middle Aged , Neoplasm Metastasis , Skin Neoplasms/immunology , Treatment Outcome
3.
Diagn Pathol ; 13(1): 50, 2018 Aug 13.
Article in English | MEDLINE | ID: mdl-30103782

ABSTRACT

BACKGROUND: Cutaneous epithelioid angiomatous nodule (CEAN) is a very rare and relatively recently recognized vascular proliferation characterized usually by minimal cytological atypia and accompanying mitotic activity. As such, CEAN represents an important diagnostic pitfall, which could lead to significant misdiagnosis and unnecessary treatment. METHODS: The clinicopathologic findings of 5 cases of CEAN were reviewed including a unique case with typical findings but also moderate cytologic atypia and brisk mitotic activity in a patient on immunosuppression. RESULTS: The cases were in 3 women and 2 men ranging in age from 18 to 61 years with lesions in the neck (2 cases), upper arm, back and shoulder. In 4 of the cases, the patients did not have any relevant potentially contributory clinical history, and in 1 case the patient was on immunosuppressive treatment. All 5 cases were superficially located within the dermis, well-circumscribed and similarly composed of epithelioid cells displaying minimal (in 4 cases) and moderate (1 case) atypia. The mitotic count ranged from 1 to 3 per 10 high power fields (HPF) in 4 cases and up to 9 per 10 HPF in the immunosuppressed patient. Atypical mitoses were not encountered in any of the cases. Two lesions that were incompletely excised recurred, but none of the patients showed distant metastases. CONCLUSION: While cytologically alarming, CEAN has a characteristic microscopic appearance and if completely excised follows an indolent course.


Subject(s)
Cell Proliferation , Epithelioid Cells/pathology , Hemangioma/pathology , Skin Neoplasms/pathology , Adolescent , Adult , Biopsy , Diagnosis, Differential , Epithelioid Cells/immunology , Female , Hemangioma/immunology , Hemangioma/surgery , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Male , Middle Aged , Mitotic Index , Neoplasm Recurrence, Local , Neoplasm, Residual , Predictive Value of Tests , Retrospective Studies , Skin Neoplasms/immunology , Skin Neoplasms/surgery , Treatment Outcome , Young Adult
4.
Clin Cancer Res ; 24(22): 5685-5696, 2018 11 15.
Article in English | MEDLINE | ID: mdl-30065096

ABSTRACT

Purpose: Regulatory T (Treg) cells expressing the transcription factor FOXP3 are essential for the maintenance of immunologic self-tolerance but play a detrimental role in most cancers due to their ability to suppress antitumor immunity. The phenotype of human circulating Treg cells has been extensively studied, but less is known about tumor-infiltrating Treg cells. We studied the phenotype and function of tumor-infiltrating Treg cells in ovarian cancer and melanoma to identify potential Treg cell-associated molecules that can be targeted by tumor immunotherapies.Experimental Design: The phenotype of intratumoral and circulating Treg cells was analyzed by multicolor flow cytometry, mass cytometry, RNA-seq, and functional assays.Results: Treg cells isolated from ovarian tumors displayed a distinct cell surface phenotype with increased expression of a number of receptors associated with TCR engagement, including PD-1, 4-1BB, and ICOS. Higher PD-1 and 4-1BB expression was associated with increased responsiveness to further TCR stimulation and increased suppressive capacity, respectively. Transcriptomic and mass cytometry analyses revealed the presence of Treg cell subpopulations and further supported a highly activated state specifically in ovarian tumors. In comparison, Treg cells infiltrating melanomas displayed lower FOXP3, PD-1, 4-1BB, and ICOS expression and were less potent suppressors of CD8 T-cell proliferation.Conclusions: The highly activated phenotype of ovarian tumor-infiltrating Treg cells may be a key component of an immunosuppressive tumor microenvironment. Receptors that are expressed by tumor-infiltrating Treg cells could be exploited for the design of novel combination tumor immunotherapies. Clin Cancer Res; 24(22); 5685-96. ©2018 AACR.


Subject(s)
Lymphocyte Activation/immunology , Melanoma/immunology , Ovarian Neoplasms/immunology , T-Lymphocytes, Regulatory/immunology , Biomarkers , Cell Line, Tumor , DNA Methylation , Female , Gene Expression Profiling , Humans , Immunophenotyping , Lymphocytes, Tumor-Infiltrating/immunology , Lymphocytes, Tumor-Infiltrating/metabolism , Male , Melanoma/genetics , Ovarian Neoplasms/genetics , Phenotype , T-Lymphocyte Subsets/immunology , T-Lymphocyte Subsets/metabolism , T-Lymphocytes, Regulatory/metabolism , Transcriptome
5.
J Cutan Med Surg ; 22(5): 519-521, 2018.
Article in English | MEDLINE | ID: mdl-29486592

ABSTRACT

Blastomyces dermatitidis is typically contracted through inhalation of the dimorphic conidia, resulting in pulmonary infection as well as extrapulmonary disease through hematogenous spread. Blastomycosis is considered one of the great mimickers in medicine, with verrucous cutaneous blastomycosis resembling skin malignancy and B dermatitidis pulmonary infections often confused with lung cancer. Cutaneous blastomycosis can also often mimic pyoderma gangrenosum and should be considered in the differential diagnosis in any suspected case. This case involves a cutaneous blastomycosis lesion of the leg that was initially diagnosed as squamous cell carcinoma, which was excised. Within a month, the atypical lesion recurred in the area and was unresponsive to antibiotic therapy, rapidly progressing in size and inflammation. We discuss the eventual diagnosis of this blastomycosis infection and the importance of ruling out cutaneous blastomycosis when managing pyoderma gangrenosum.


Subject(s)
Blastomycosis , Pyoderma Gangrenosum , Aged, 80 and over , Carcinoma, Squamous Cell , Diagnosis, Differential , Female , Humans , Lower Extremity/pathology , Lower Extremity/surgery , Skin/pathology
6.
Transpl Infect Dis ; 19(4)2017 Aug.
Article in English | MEDLINE | ID: mdl-28326649

ABSTRACT

Trichodysplasia spinulosa (TS) is a rare dermatologic complication associated with the immunosuppressive therapy used in solid organ transplantation. The distinctive clinical manifestation of this condition is spiny follicular papules on the face, ears, extremities, and trunk. Histopathologically, abnormally maturing hair follicles with hyperkeratotic material are noted. The condition is produced by the trichodysplasia spinulosa-associated polyomavirus. Treatment of this condition in the past has entailed a reduction in immunosuppression, topical agents such as cidofovir or retinoids, or oral valganciclovir. Herein, we report a case of generalized TS treated successfully with leflunomide.


Subject(s)
Hair Diseases/drug therapy , Immunologic Factors/therapeutic use , Isoxazoles/therapeutic use , Liver Transplantation/adverse effects , Polyomavirus Infections/drug therapy , Pruritus/drug therapy , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/adverse effects , Adult , Cyclosporine/administration & dosage , Cyclosporine/adverse effects , Diagnosis, Differential , Hair Diseases/diagnosis , Hair Diseases/pathology , Hair Diseases/virology , Hair Follicle/pathology , Humans , Immunosuppression Therapy , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Leflunomide , Male , Polyomavirus Infections/diagnosis , Polyomavirus Infections/pathology , Polyomavirus Infections/virology , Pruritus/diagnosis , Pruritus/pathology , Pruritus/virology
7.
J Clin Pathol ; 69(9): 750-3, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27235536

ABSTRACT

The BAP1 gene (BRCA1-associated protein 1) is a tumour suppressor gene that encodes a deubiquitinating enzyme (DUB), regulating key cellular pathways, including cell cycle, cellular differentiation, transcription and DNA damage response. Germline BAP1 mutations cause a novel cancer syndrome characterised by early onset of multiple atypical Spitz tumours and increased risk of uveal and cutaneous melanoma, mesothelioma, renal cell carcinoma and various other malignancies. Recognising the clinicopathological features of specific BAP1-deficient tumours is crucial for early screening/tumour detection, with significant impact on patient outcome.


Subject(s)
Germ-Line Mutation , Melanoma/genetics , Mesothelioma/genetics , Nevus, Epithelioid and Spindle Cell/genetics , Skin Neoplasms/genetics , Tumor Suppressor Proteins/genetics , Ubiquitin Thiolesterase/genetics , Humans , Melanoma/metabolism , Melanoma/pathology , Mesothelioma/metabolism , Mesothelioma/pathology , Nevus, Epithelioid and Spindle Cell/metabolism , Nevus, Epithelioid and Spindle Cell/pathology , Skin Neoplasms/metabolism , Skin Neoplasms/pathology , Tumor Suppressor Proteins/metabolism , Ubiquitin Thiolesterase/metabolism , Melanoma, Cutaneous Malignant
9.
J Cutan Med Surg ; 20(4): 337-9, 2016 Jul.
Article in English | MEDLINE | ID: mdl-26896181

ABSTRACT

BACKGROUND AND OBJECTIVE: While clinical symptoms of strongyloidiasis are often nonspecific, larva currens (with erythematous, serpiginous, and pruritic papules and plaques) should prompt investigation including stool microscopy, serology, and skin biopsy of the lesion. Appropriate diagnosis and treatment with ivermectin is necessary, especially in the immunocompromised patient who is at increased risk for hyperinfection syndrome and disseminated disease. CONCLUSION: We present a 61-year-old immunocompromised man with presentation of larva currens of cutaneous strongyloides infection without symptoms of hyperinfection or disseminated disease.


Subject(s)
Immunocompromised Host , Skin Diseases, Parasitic/diagnosis , Strongyloidiasis/diagnosis , Animals , Humans , Male , Middle Aged , Myelodysplastic Syndromes/drug therapy , Myelodysplastic Syndromes/immunology , Skin Diseases, Parasitic/etiology , Skin Diseases, Parasitic/therapy , Strongyloidiasis/etiology , Strongyloidiasis/therapy
10.
Cancer Immunol Res ; 4(3): 175-8, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26822024

ABSTRACT

Anti-PD-1 inhibitors have significant activity in metastatic melanoma. Responses often occur early and may be sustained. The optimal duration of treatment with these agents is unknown. Here, we report the case of a 51-year-old woman treated with pembrolizumab, as part of the Keynote-001 trial, as first-line treatment for metastatic disease. She experienced a complete response after 13.8 months of treatment with no adverse events. One month after the last drug infusion and 18 months from starting treatment, the patient presented with eosinophilic fasciitis. She then developed acute confusion and weakness, thought to be due to intracranial vasculitis. High-dose steroids were initiated with resolution of the fasciitis. Aspirin was commenced for presumed vasculitis with resolution of the neurologic symptoms. To our knowledge, there are no previous reports of eosinophilic fasciitis or cerebral vasculitis due to anti-PD-1 agents. This case demonstrates that toxicity may occur in association with pembrolizumab treatment after a prolonged period of treatment without toxicity. Future trials should explore the optimal duration of treatment with pembrolizumab.


Subject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Antineoplastic Agents/adverse effects , Brain Diseases/diagnosis , Eosinophilia/diagnosis , Fasciitis/diagnosis , Melanoma/drug therapy , Skin Neoplasms/drug therapy , Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents/therapeutic use , Brain Diseases/chemically induced , Eosinophilia/chemically induced , Fasciitis/chemically induced , Female , Humans , Melanoma/secondary , Middle Aged , Skin Neoplasms/pathology
11.
Am J Med ; 128(11): 1182-5, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26164562
12.
J Low Genit Tract Dis ; 19(4): 350-3, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26225944

ABSTRACT

OBJECTIVES: The aim of this work was to determine molecular characteristics and specifically, the frequency of BRAF, C-KIT, and NRAS mutations in vulvar and vaginal melanomas. METHODS: A retrospective review of all cases of vulvar and vaginal melanoma between 2002 and 2013 was performed. We reviewed the clinical and histological characteristics of all cases and performed genotyping studies on cases that had tissue available for the study, using next-generation sequencing. RESULTS: We identified 33 vulvar and 11 vaginal melanomas in women with mean ages 58 and 61 years, respectively. Next-generation sequencing analysis on 20 cases (15 vulvar and 5 vaginal) identified a BRAF mutation in 7.6%, C-KIT mutation in 27.6%, NRAS mutation in 27.6%, and TP53 mutation in 7.6% of the vulvar cases. We detected only a single TP53 mutation in the vaginal cases. We did not identify any statistically significant relationship between the mutation status and patients' outcome, depth of invasion, ulceration, stage at presentation, or lymph node metastasis. CONCLUSIONS: BRAF mutations are infrequent, whereas C-KIT and NRAS mutations are seen with higher frequency in vulvar melanomas than melanomas of other sites. These mutations can be considered as potential therapeutic targets in patients harboring them. Further studies are necessary to increase our understanding of mutational events occurring in melanoma of the lower female genital tract and their relationship with clinical parameters/outcome.


Subject(s)
GTP Phosphohydrolases/genetics , Melanoma/pathology , Membrane Proteins/genetics , Proto-Oncogene Proteins B-raf/genetics , Proto-Oncogene Proteins c-kit/genetics , Vaginal Neoplasms/pathology , Vulvar Neoplasms/pathology , Adolescent , Adult , Aged , Aged, 80 and over , DNA Mutational Analysis , Female , High-Throughput Nucleotide Sequencing , Histocytochemistry , Humans , Melanoma/genetics , Middle Aged , Retrospective Studies , Sequence Analysis, DNA , Vaginal Neoplasms/genetics , Vulvar Neoplasms/genetics , Young Adult
14.
J Cutan Med Surg ; 18(6): 420-3, 2014 Nov.
Article in English | MEDLINE | ID: mdl-25348764

ABSTRACT

BACKGROUND AND OBJECTIVE: Cutaneous polyarteritis nodosa, a form of vasculitis affecting the small to medium sized arteries, most commonly presents as tender subcutaneous nodules over the lower legs and feet. Other features include livedo reticularis, skin ulcers and tender indurated plaques. CONCLUSION: We report a 51-year old woman with a primarily livedo reticularis presentation of cutaneous polyarteritis nodosa without a nodular component.


Subject(s)
Livedo Reticularis/etiology , Polyarteritis Nodosa/complications , Polyarteritis Nodosa/diagnosis , Female , Humans , Leg , Middle Aged , Polyarteritis Nodosa/pathology
15.
Semin Diagn Pathol ; 30(3): 234-44, 2013 Aug.
Article in English | MEDLINE | ID: mdl-24144292

ABSTRACT

Primary neuroendocrine carcinoma of the skin, or Merkel Cell carcinoma (MCC), is a rare but aggressive tumor. Many recent advances on the morphology, immunophenotype, and pathogenesis have come to light in recent years. This review highlights the clinical features, varying histologies, histogenesis, advances in molecular pathology, prognosis, and current management of MCC. It also aims to aid in the differential diagnosis, with an emphasis on neuroendocrine tumors, and approach to the diagnosis of MCC with the use of immunohistochemistry and molecular studies.


Subject(s)
Carcinoma, Neuroendocrine/pathology , Skin Neoplasms/pathology , Humans
16.
Head Neck ; 35(2): 184-9, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22307956

ABSTRACT

BACKGROUND: The purpose of this study was to determine the expression pattern of the Merkel cell polyomavirus (MCPyV) large T-protein antigen in patients with Merkel cell carcinoma. METHODS: A tissue microarray (TMA) containing 30 specimens was constructed and stained for the MCPyV large T protein. Immunohistochemical expression was determined semiquantitively and was compared to patients' outcome. RESULTS: Nuclear expression of MCPyV large T protein was detected in 29 of 30 specimens (97%). In particular, 60% to 100%, 30% to 60%, and 10% to 30% of tumor cells were positive in 27 specimens (90%), 1 (3%), and 1 (3%), respectively. There was no difference in positivity between primary and metastatic lesions. Clinical data could not be correlated to MCPyV large T-protein expression. CONCLUSION: MCPyV large T protein was significantly overexpressed in 97% of all specimens. Although we could not demonstrate a predictive effect, MCPyV large T protein may represent a molecular marker with utility in pathological diagnosis as well as a potential new therapeutic target in patients with Merkel cell carcinoma.


Subject(s)
Antigens, Polyomavirus Transforming/genetics , Carcinoma, Merkel Cell/genetics , Polyomavirus Infections/immunology , Skin Neoplasms/genetics , Tumor Virus Infections/immunology , Adult , Aged , Aged, 80 and over , Biopsy, Needle , Carcinoma, Merkel Cell/mortality , Carcinoma, Merkel Cell/therapy , Carcinoma, Merkel Cell/virology , DNA, Viral/analysis , Female , Gene Expression Regulation, Neoplastic , Humans , Immunohistochemistry , Male , Merkel cell polyomavirus/immunology , Middle Aged , Polyomavirus Infections/mortality , Polyomavirus Infections/physiopathology , Prognosis , Registries , Retrospective Studies , Skin Neoplasms/mortality , Skin Neoplasms/therapy , Skin Neoplasms/virology , Survival Analysis , Tumor Virus Infections/mortality , Tumor Virus Infections/physiopathology
17.
Head Neck ; 35(3): 316-20, 2013 Mar.
Article in English | MEDLINE | ID: mdl-22367747

ABSTRACT

BACKGROUND: The purpose of this study was to identify prognostic factors predicting outcomes in sebaceous gland carcinomas. METHODS: We conducted a retrospective medical chart review of patients with sebaceous carcinomas of periorbital (n = 33) and extraorbital sites (n = 13). RESULTS: Patients with periorbital tumors had higher recurrence rates than did patients with extraorbital tumors (64% vs 23%; p = .032). Patients who were older than 60 years (p = .035) and had lower eyelid tumors (p < .0001) had a lower disease-free survival rate than did patients with upper eyelid tumors. Patients with sebaceous carcinomas had a high rate (60%) of occult lymph node metastases. CONCLUSION: Periorbital tumors are associated with poorer outcomes than are extraorbital tumors. Lower eyelid carcinomas have the worst prognosis and should be treated more aggressively. Our findings of a high incidence of occult neck disease and a high rate of regional recurrence in patients with sebaceous carcinomas support the consideration of prophylactic elective neck dissections for treating such patients.


Subject(s)
Head and Neck Neoplasms/pathology , Orbital Neoplasms/pathology , Sebaceous Gland Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Disease-Free Survival , Female , Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/therapy , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Orbital Neoplasms/mortality , Orbital Neoplasms/therapy , Prognosis , Retrospective Studies , Sebaceous Gland Neoplasms/mortality , Sebaceous Gland Neoplasms/therapy , Survival Rate
18.
Head Neck ; 35(5): 642-8, 2013 May.
Article in English | MEDLINE | ID: mdl-22715107

ABSTRACT

BACKGROUND: The aim of this study was to identify new target proteins in sebaceous gland carcinoma. METHODS: A tissue microarray containing 115 core biopsies was constructed and stained for proteins involved in carcinogenesis, angiogenesis, inflammation, and cell-to-cell contact. Two investigators independently determined protein expression of all antibodies. RESULTS: Vascular endothelial growth factor receptor 2 (VEGFR-2), platelet-derived growth factor receptor alpha and beta (PDGFR-α/-ß), epidermal growth factor receptor (EGFR), cyclooxygenase 1 and 2 (Cox-1/-2), myeloid cell leukemia sequence 1 (Mcl-1), matrix metalloproteinase 1 (MMP-1), CD9, Bmi-1, 14-3-3σ, glutathione S-transferase pi (Gstπ), and members of the sonic hedgehog (SHH), AKT, and WNT pathways were significantly overexpressed in sebaceous gland carcinomas. CONCLUSIONS: We have demonstrated for the first time that proteins related to angiogenesis, inflammation, and cell proliferation are overexpressed in sebaceous gland carcinomas. These proteins may hold promise as novel therapeutic targets for the treatment of sebaceous gland carcinoma.


Subject(s)
Gene Expression Regulation, Neoplastic , Head and Neck Neoplasms/metabolism , Neoplasm Proteins/metabolism , Sebaceous Gland Neoplasms/metabolism , Adult , Aged , Aged, 80 and over , Cell Adhesion Molecules , Cyclooxygenase 1/metabolism , Cyclooxygenase 2/metabolism , Female , Hedgehog Proteins/metabolism , Humans , Immunohistochemistry , Male , Matrix Metalloproteinase 1/metabolism , Middle Aged , Myeloid Cell Leukemia Sequence 1 Protein/metabolism , Receptor, Platelet-Derived Growth Factor alpha/metabolism , Receptor, Platelet-Derived Growth Factor beta/metabolism , Tissue Array Analysis , Vascular Endothelial Growth Factor Receptor-2/metabolism , Wnt Signaling Pathway/physiology
19.
Am J Dermatopathol ; 34(2): 192-3, 2012 Apr.
Article in English | MEDLINE | ID: mdl-22441369

ABSTRACT

Bullous pemphigoid is an inflammatory autoimmune subepidermal bullous disease with distinct immunohistological features. We report an unusual case of a 59-year-old woman with a bullous eruption whose lesional skin biopsy showed a subepidermal blister with a linear arrangement of neutrophils, mimicking linear IgA bullous dermatosis. However, direct immunofluorescence studies demonstrated IgG and C3 linear deposition along the basement membrane zone, compatible with bullous pemphigoid. We suggest that bullous pemphigoid should therefore be considered in the differential diagnosis of neutrophil-rich subepidermal bullous diseases along with dermatitis herpetiformis and linear IgA.


Subject(s)
Neutrophils/pathology , Pemphigoid, Bullous/pathology , Female , Humans , Middle Aged
20.
J Pathol Inform ; 3: 2, 2012.
Article in English | MEDLINE | ID: mdl-22439122

ABSTRACT

BACKGROUND: There is a need for telemedicine, particularly in countries with large geographical areas and widely scattered low-density communities as is the case of the Canadian system, particularly if equality of care is to be achieved or the difference gap is to be narrowed between urban centers and more peripheral communities. AIMS: 1. To validate teledermatopathology as a diagnostic tool in under-serviced areas; 2. To test its utilization in inflammatory and melanocytic lesions; 3. To compare the impact of 20× (0.5 µm/pixel) and 40× (0.25 µm/pixel) scans on the diagnostic accuracy. MATERIALS AND METHODS: A total of 103 dermatopathology cases divided into three arms were evaluated by two pathologists and results compared. The first arm consisted of 79 consecutive routine cases (n=79). The second arm consisted of 12 inflammatory skin biopsies (n=12) and the third arm consisted of 12 melanocytic lesions (n=12). Diagnosis concordance was used to evaluate the first arm. Whereas concordance of preset objective findings were used to evaluate the second and third arms. RESULTS: The diagnostic concordance rate for the first arm was 96%. The concordance rates of the objective findings for the second and third arms were 100%. The image quality was deemed superior to light microscopy for 40× scans. CONCLUSION: The current scanners produce high-resolution images that are adequate for evaluation of a variety of cases of different complexities.

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