ABSTRACT
The presence of CD 1a+ dendritic cells (DC) has been well described in T-cell lymphoproliferative disorders, and the presence of large numbers of DCs has rarely been reported as a mimicker of Langerhans cell histiocytsis (LCH). We present the case of a 56-year-old female with a solitary nodule on the chin whose case was referred to our institution for confirmation of the diagnosis of LCH. Skin biopsy showed an ulcerated nodule containing a wedge-shaped infiltrate comprised of large atypical cells and cells with prominent grooved nuclei. The constellation of histologic and immunologic features favored a CD30 lymphoproliferative disorder of T-cell lineage even though there were accompanying numerous dendritic histiocytes and CD1a positive Langerhans cells. The sheets of CD30 positive atypical lymphoid cells which express T-cell markers were consistent with CD30 positive lymphoproliferative disease and favor CD30 positive anaplastic large-cell lymphoma (ALCL) over Langerhans histiocytosis. The absence of Anaplastic Lymphoma Kinase (ALK) staining favored a primary cutaneous origin. This case signifies a CD 30+ ALCL of the skin which histopathologically mimics a LCH. Ezra N, Van Dyke GS, Binder SW. CD30 positive anaplastic large-cell lymphoma (ALCL) mimicking Langerhans cell histiocytosis (LCH).
Subject(s)
Histiocytosis, Langerhans-Cell/pathology , Ki-1 Antigen/biosynthesis , Lymphoma, Large-Cell, Anaplastic/pathology , Biomarkers, Tumor/analysis , Diagnosis, Differential , Female , Histiocytosis, Langerhans-Cell/metabolism , Humans , Immunohistochemistry , Lymphoma, Large-Cell, Anaplastic/metabolism , Middle AgedABSTRACT
Poliosis is a localized patch of gray or white hair. Because it can be seen with a variety of disorders and drugs, a full history and exam is indicated. Additionally, it can be associated with underlying benign and malignant tumors, necessitating histological identification. We review the lesions that are reported with poliosis. In addition, we will report a case of poliosis overlying an intradermal nevus with congenital as well as blue nevus features. To the best of our knowledge, blue nevus features associated with poliosis have not been previously described.
Subject(s)
Hair Color , Head and Neck Neoplasms/complications , Nevus, Blue/complications , Pigmentation Disorders/etiology , Scalp/pathology , Skin Neoplasms/complications , Adolescent , Female , Head and Neck Neoplasms/congenital , Head and Neck Neoplasms/pathology , Humans , Melanocytes/pathology , Nevus, Blue/congenital , Nevus, Blue/pathology , Pigmentation Disorders/pathology , Skin Neoplasms/congenital , Skin Neoplasms/pathologyABSTRACT
BACKGROUND: Among human immunodeficiency virus-infected individuals, facial lipoatrophy has become epidemic. Those affected are stigmatized, leading to psychological distress, social and career impediments, and impaired compliance to human immunodeficiency virus medications. Temporary treatment options are limited by excessive cost, necessity of frequent treatments, and lack of a natural look or feel beneath the skin. Affected patients require more persistent, affordable, safe, and effective treatment options. OBJECTIVE: The objective was to evaluate the safety and efficacy of highly purified 1000-cSt silicone oil injected by microdroplet serial puncture technique for the treatment of human immunodeficiency virus-associated lipoatrophy. METHODS: Data on 77 patients with a complete correction were analyzed to determine the number of treatments, amount of silicone, and time required to reach complete correction, relative to initial severity. RESULTS: The volume of silicone, number of treatments, and time required to reach a complete correction were directly related to initial severity of lipoatrophy (p < 0.0001). Supple, even facial contours were routinely restored, with all patients tolerating treatments well. No adverse events were noted. CONCLUSION: In this pilot trial, we have demonstrated that highly purified 1000-cSt silicone oil is a safe and effective treatment option for human immunodeficiency virus facial lipoatrophy. Longer-term safety and efficacy in human immunodeficiency virus patients remain to be proven.
Subject(s)
HIV-Associated Lipodystrophy Syndrome/therapy , Silicone Oils/administration & dosage , Adult , Dimethylpolysiloxanes , Face , Female , Humans , Injections, Subcutaneous , Male , Middle Aged , Pilot Projects , Silicones , Treatment OutcomeABSTRACT
Acne vulgaris is a common cutaneous disorder of the pilosebaceous follicle. More than 45 million people are affected with acne vulgaris. In addition, 80% of people in the United States report that they suffered from acne at one point in life. It is estimated that US consumers spend $1.2 billion each year for the treatment of acne. Typically, lesions are pleomorphic and range from open and closed comedones to inflammatory papules, pustules, cysts, and nodules, and scarring may result. The disease is important, with a significant effect on patients' self-esteem. The pathogenesis is only partially understood and is multifactorial. Successful management of acne requires an understanding of the pathophysiology of disease. The first half of this review discusses new discoveries in the pathogenesis of acne, and the second half introduces new and time-honored therapies.
