ABSTRACT
SARS-CoV-2 infection can manifest many rashes. However, thrombotic retiform purpura rarely occurs during COVID-19 illness. Aggressive anti-COVID-19 therapy with a high-dose steroid regimen led to rapid recovery. This immunothrombotic phenomenon likely represents a poor type 1 interferon response and complement activation on the endothelial surface in response to acute infection.
ABSTRACT
Melanomas, like nonmelanoma skin cancers, are known to be causally related to sun exposure. It is therefore not surprising to see benign nevi and melanomas in a background of solar damage, which at times may complicate their distinction. Because of their long-standing nature, nevi often occur before the development of solar elastosis and as such are intimately associated with the solar elastosis. In contrast, visible solar elastosis often occurs before the development of melanoma, in which case the band of solar elastosis is displaced downward from the overlying invasive melanoma and/or its host response. We describe 4 cases in which invasive melanoma cells were intimately admixed with actinically damaged elastin fibers in the absence of a prominent host response. In each case, melanoma cells were admixed with prominent solar elastosis and lacked a significant host response, suggesting that they were either histiocytes or an associated melanocytic nevus. Recognition of this potential pitfall may be helpful in the diagnosis of primary/in-transit/satellite/metastatic melanoma as well as when evaluating marginal status and determining Breslow thickness.
Subject(s)
Elastic Tissue/pathology , Melanoma/diagnosis , Melanoma/pathology , Nevus/diagnosis , Skin Diseases/diagnosis , Skin Diseases/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Sunlight/adverse effects , Aged , Diagnosis, Differential , Female , Humans , Male , Melanoma/complications , Middle Aged , Nevus/pathology , Skin Diseases/complications , Skin Neoplasms/complications , Melanoma, Cutaneous MalignantABSTRACT
Nodular cutaneous amyloidosis (NCA) is the rarest form of primary cutaneous amyloidosis. The amyloid fibrils of NCA are not unique to NCA but are also the prevailing amyloid component in primary systemic amyloidosis (PSA) and myeloma-associated systemic amyloidosis. Age of presentation in NCA has ranged from 20 to 87 years without a clear gender predilection. Progression from NCA to primary systemic amyloidosis has been reported, with an estimated lifetime risk of approximately 7 percent, prompting the need for appropriate follow up to evaluate for the presence of systemic amyloidosis. We report a case of nodular cutaneous amyloidosis in an otherwise healthy 62-year-old woman and we review the literature.
