皮肤纤维瘤中平滑肌肌动蛋白和结蛋白的表达及意义

皮肤纤维瘤(dermatofibroma)是一种常见的皮肤良性肿瘤,其组织病理表现多种多样[1],有时难以与其他间叶来源的肿瘤鉴别,不典型的皮肤纤维瘤与平滑肌来源的肿瘤鉴别非常困难[1],这时就需要结合免疫组化结果来判断组织来源.     

皮肤纤维瘤:是炎性疾病还是良性肿瘤?

最近有报道认为细胞遗传学的克隆形成能力分析表明皮肤纤维瘤是一种良性肿瘤。作者对此观点有异议 ,认为皮肤纤维瘤既不是一种良性肿瘤 ,也不是一种恶性肿瘤 ,而是一种炎性疾病。为了充分讨论这个问题 ,首先需要明确它们各自的精确定义。炎性疾病含有炎性细胞浸润 (还包括肉芽组织、成纤维细胞和成肌纤维细胞 ) ,在皮肤和皮下组织可表现为以下 9种反应类型之一 :皮肤浅层血管周围炎症、皮肤全层血管周围炎症、结节性和弥漫性皮炎、血管炎、表皮内囊状皮炎、表皮下囊状皮炎、毛囊炎、毛囊周炎、纤维组织增生性皮炎和脂膜炎。而肿瘤性疾病至少…     

一例具有异常表现的皮肤纤维瘤

皮肤纤维瘤系指一组有各种不同组织象的皮肤反应的通称。病变局限性,无包膜,主要由成纤维细胞组成(皮肤纤维瘤),或主要由泡沫样组织细胞及新生血管组成(硬化性血管瘤),乃至主要由组织细胞所组成(组织细胞瘤)。本病是一种常见的良性肿瘤,具有特殊的临床表现易于诊断。当出现不典型损害时,则与其他疾病相似。作者报导一例不典型皮肤纤维瘤,讨论临床鉴别诊断及复习有关资料。患者男性,52岁。右下肢胫前缓慢生长角化过     

极早早产儿的自发性皮肤斑萎缩

皮肤斑萎缩的临床特征是皮肤的斑状凹陷或松垂,组织相示真皮弹力纤维的缺陷。文献上一般将其分为两类:一是原发性,即斑状萎缩前无炎症反应;二是继发性,即斑状萎缩是对先前炎症病变的一种反应过程。这两种类型都可见于儿童中,但在出生后2～3个月的极早早产儿中则从未报道过。     

组织病理学表现为皮肤纤维瘤改变的泛发性瘢痕疙瘩1例

瘢痕疙瘩系局部皮肤受损伤后,在修复过程中结缔组织对创伤的反应超过正常范围而形成的.笔者诊治1例组织病理学表现为皮肤纤维瘤改变.而临床表现为泛发性瘢痕疙瘩的患者,现报告如下.     

皮肤血管炎组织病理学研究进展

皮肤血管炎为原发于皮肤血管壁及其周围组织的炎症性疾病。病理变化为血管壁及其周围炎症细胞浸润、纤维蛋白样变性、血管内皮细胞肿胀等。由于皮肤血管炎的临床表现复杂，所以除病史、临床表现和实验室检查外，组织病理学检查是皮肤血管炎诊断的重要依据。本文就近年来有关血管炎组织病理学研究进展综述如下。     

皮肤淋巴细胞相关抗原+T细胞与皮肤病

皮肤淋巴细胞相关抗原是具有皮肤趋向性T细胞的一种归巢受体,类似于唾液酸化路易糖抗原的糖类结构。皮肤淋巴细胞相关抗原阳性T细胞具有对皮肤微环境中抗原的优先应答性、向炎症皮肤迁移及可在血液和皮肤之间再循环的特性,并与一些疾病的发病机制密切相关。     

皮肤淋巴细胞相关抗原+T细胞与皮肤病

皮肤淋巴细胞相关抗原是具有皮肤趋向性T细胞的一种归巢受体,类似于唾液酸化路易糖抗原的糖类结构.皮肤淋巴细胞相关抗原阳性T细胞具有对皮肤微环境中抗原的优先应答性、向炎症皮肤迁移及可在血液和皮肤之间再循环的特性,并与一些疾病的发病机制密切相关.     

皮肤淋巴细胞相关抗原^＋T细胞与皮肤病

皮肤淋巴细胞相关抗原是具有皮肤趋向性T细胞的一种归巢受体,类似于唾液酸化路易糖抗原的糖类结构.皮肤淋巴细胞相关抗原阳性T细胞具有对皮肤微环境中抗原的优先应答性、向炎症皮肤迁移及可在血液和皮肤之间再循环的特性,并与一些疾病的发病机制密切相关.     

白介素10家族的新成员:白介素20

白介素 2 0是一种新发现的细胞因子 ,属于白介素 10家族 ,其主要靶器官是皮肤 ,通过与细胞表面受体特异性结合 ,参与皮肤炎症反应。白介素 2 0的转基因小鼠表现出类似人类银屑病的症状。白介素 19、白介素 2 4、白介素 2 2与白介素 2 0的受体亚单位有交叉反应 ,并且不同的受体途径其反应灵敏度不同     

HHV-8 DNA sequences in the peripheral blood and skin lesions of an HIV-negative patient with multiple eruptive dermatofibromas: implications for the detection of HHV-8 as a diagnostic marker for Kaposi's sarcoma

BACKGROUND: Multiple eruptive dermatofibroma (MEDF) is a rare disorder seen in immunocompromised patients, simulating Kaposi's sarcoma (KS). Whereas KS is strongly associated with human herpesvirus 8 (HHV-8), the virus has never been detected in MEDF until now. OBJECTIVE: To present a patient with MEDF who showed no signs of immunodeficiency but was seropositive for HHV-8 antibodies and demonstrated HHV-8 DNA both in the peripheral blood and lesional skin of MEDF. METHODS: Clinical, histological and serological investigations were performed as well as polymerase chain reaction (PCR) studies and in situ hybridization (ISH). RESULTS: A 35-year-old white man with suspected KS was referred for evaluation of multiple pigmented nodules and patches. Biopsies revealed features of dermatofibroma, superficial fibrosing dermatitis and scar. One of the nodular lesions harbored HHV-8 DNA sequences. A faint amplification product was detected in the superficial fibrosing dermatitis lesion, while no HHV-8 sequences were found in normal skin and scar. Whole-blood samples and serum were positive for HHV-8. None of the skin lesions shown to harbor HHV-8 DNA sequences by nested PCR displayed a signal for HHV-8 RNA by ISH. Repetitive peripheral blood examinations did not reveal any serum antibodies against or antigens of HIV. Serum antibodies against the HHV-8 capsid antigen orf 65.2 were detected. CONCLUSION: Results of PCR studies and ISH indicate that the presence of HHV-8 in the lesional tissue was probably blood-borne due to viremia and not due to viral replication in tumor cells. The presence of HHV-8 is not fully restricted to KS. The differential diagnosis of KS and its simulators should be based on an integrative analysis of all available clinicopathological and molecular data and should not rely exclusively or predominantly on the presence or absence of HHV-8.     

Reticulohistiocytosis: different dermatoscopic faces and a good response to methotrexate treatment

The reticulohistiocytoses are a rare group of non‐Langerhans cell histiocytic disorders. Recently, dermatoscopic features have been reported for some of the xanthomatous disorders. We report a case of diffuse cutaneous reticulohistiocytosis with 29 reticulohistiocytomas. On dermatoscopy of these lesions, we saw three typical features: a homogeneous pattern with various shades of yellow (defined previously as a ‘setting‐sun’ pattern), brown reticular structures, and central white scar‐like patches and streaks. The setting‐sun pattern was most commonly seen in combination with brown reticular structures. In four lesions, brown reticular structures surrounded a central white scar‐like patch resembling that of a dermatofibroma. However, the presence of the setting‐sun pattern in the background gave a different hue to that of the peripheral network seen in a dermatofibroma. A marked clinical improvement was associated with 6 months of systemic methotrexate treatment. Dermatoscopy may aid in the diagnosis of xanthomatous diseases. For this patient, methotrexate was beneficial.     

Fibronectin. Localization in normal human skin, granulation tissue, hypertrophic scar, mature scar, progressive systemic sclerotic skin, and other fibrosing dermatoses

The histologic localization of fibronectin (FN) in normal human skin, granulation tissue, hypertrophic scar, mature scar, progressive systemic sclerotic skin, and tissue of other fibrotic disorders was investigated by an indirect immunofluorescence technique using specific antiserum prepared in rabbits against purified human plasma FN. In granulation tissue that developed just after traumatic wounding, FN seemed to increase remarkably in the wound as a fibrillar network. In the hypertrophic scar, one to five years after wounding, FN was detected in a linear or curling arrangement throughout the dermis. On the contrary, FN gradually decreased in the wound of the mature scar five to 20 years after wounding. There were some interesting observations among other diseases. In the skin of patients with progressive systemic sclerosis and morphea, FN was found to be localized faintly on the dermoepidermal junction and papillary dermis. In the involved skin of dermatofibroma, FN was observed in a curling arrangement throughout the dermis.     

Dermatofibroma with granular cells

A new histologic variant of dermatofibroma, only briefly alluded to in dermatological literature is reported. This tumor was located in the back of a 24-year-old man. It was present for about 2 years and had a history of trauma 2 months before excision. The lesion showed similar characteristics to those of conventional dermatofibroma as well as the presence of groups of granular cells identical to those seen in granular cell tumors. It is important to recognize dermatofibroma with granular cells because it may be confused with a variety of benign or malignant soft tissue tumors containing similar granular cells that entail different significance or prognosis. The immunohistochemical study supports a granular cell change in a dermatofibroma instead of a granular cell tumor that has been traumatized, with secondary formation of a dermatofibroma reaction.     

Aneurysmal Benign Fibrous Histiocytoma with Atrophic Features

Aneurysmal benign fibrous histiocytoma is an uncommon pathologic variant of dermatofibroma. In addition to the features of a typical dermatofibroma, it has large cleft-like or cavernous blood-filled spaces with numerous hemosiderin pigments. It should be differentiated from angiomatoid malignant fibrous histiocytoma, malignant melanoma, and vascular tumors such as Kaposi''s sarcoma and angiosarcoma. Atrophic dermatofibroma is also a rare variant of dermatofibroma, and the combination of aneurysmal and atrophic features is rarer still. We report a case of aneurysmal benign fibrous histiocytoma with atrophic features in a 27-year-old male who had a grayish-brown atrophic patchy lesion on his back for 2 years.     

A case of polypoid dermatofibroma

Dermatofibroma is a common benign cutaneous tumor that usually appears as a slowly growing firm nodule. Polypoid nodular dermatofibroma is a variant type that is rarely encountered. We reported a case of polypoid dermatofibroma with a review of the previously reported cases. Polypoid dermatofibroma tends to arise on the leg, especially below the knee. Its size is often larger than that of common dermatofibroma. It is speculated that both the underlying firm tissue and long-term development may lead the tumor to form a polypoid appearance.     

The Atrophic Dermatofibroma: A Delled Dermatofibroma

Atrophic dermatofibroma has been proposed as a term to designate a new and specific type of dermatofibroma. We report the clinical and histopathological findings in two cases of atrophic dermatofibroma. The peculiar morphology of these lesions simply represents a conspicuous example of the frequently seen central depression in dermatofibroma. On histopathology, no authentic atrophy is present, because the thinning of the dermis compared with that of the adjacent non-lesional skin results from this depression rather than from loss of tissue of the dermis. Delled dermatofibroma is a more appropriate appellation than atrophic dermatofibroma, because of the striking shape of these lesions.     

Immunohistochemical analysis of platelet-derived growth factor and its receptors in fibrohistiocytic tumors

Platelet-derived growth factor (PDGF) is known to stimulate the proliferation of fibroblasts, although the role of PDGF and its receptors in the development of fibrohistiocytic tumors has not been clarified. In this study, we investigated this role by immunohistochemically staining PDGF and PDGF β-receptors in paraffin-embedded dermatofibroma (DF), dermatofibrosarcoma protuberans (DFSP) and malignant fibrous histiocytoma (MFH) tissue. We also immunohistochemically investigated the relationship between PDGF β-receptors and CD34, which is a known immunohistochemical marker for DFSP. Immunohistochemical studies using anti-PDGF-AA or BB antibodies showed that PDGF-AA and BB was found in 20 to 40% of the tumor cells in DF, DFSP, and MFH. No definite relationship for each tumor type was found. The expression of PDGF β-receptors in DFSP and that of MFH tissue was significantly greater in comparison to DF and scar tissue. The expression of CD34 and PDGF β-receptors in DFSP was observed in identical areas. These findings suggest that autocrine or paracrine growth stimulation, through PDGF β-receptors, is related to the tumorous proliferation of fibrohistiocytic tumors, and the expression of PDGF β-receptors might play a role in the proliferation of CD34 positive tumor cells.     

Dermatofibroma with sclerotic areas resembling a sclerotic fibroma of the skin

BACKGROUND: Dermatofibromas are common benign tumors that occur as single or multiple nodules on the extremities in adults. Sclerotic fibroma of the skin (SFS) is a benign tumor characterized histopathologically by a well-demarcated, non-encapsulated dermal nodule composed of hypocellular, sclerotic collagen bundles with prominent clefts. The pathogenesis of these two conditions is still in dispute. METHODS: We present a case of dermatofibroma with sclerotic areas resembling a sclerotic fibroma of the skin and a review of the literature. RESULTS: The tumor showed a well-demarcated dermal, fibrocollagenous tumor with three different histopathological features. One-fourth of the lesion was consistent with dermatofibroma. Another area adjacent to dermatofibroma revealed hyalinized eosinophilic collagen bundles arranged in the characteristic interwoven pattern with prominent clefts, as is described in sclerotic fibroma of the skin. One-half of the lesion between the dermatofibroma and sclerotic fibroma showed transitional changes from dermatofibroma to sclerotic fibroma. CONCLUSION: According to these findings, the possibility that sclerotic fibroma is an ancient or degenerated stage of dermatofibroma cannot be completely ruled out, but some authors still consider that dermatofibroma and sclerotic fibroma of the skin are completely different neoplasms.     

Sebaceous hyperplasia: a clue to the diagnosis of dermatofibroma

We describe a man with an indurated lesion on his upper back that showed a dermatofibroma with overlying sebaceous hyperplasia. Characteristic dermal features of a dermatofibroma may be sparse or absent in a lesional specimen that has been submitted subsequent to a superficial shave biopsy. Hyperplasia of sebaceous glands in a nonfacial lesion is a histologic feature that should prompt the search for a dermatofibroma in the underlying dermis.