Vincristine‐induced Eccrine Squamous Syringometaplasia

Abstract: Eccrine squamous syringometaplasia is a histologic finding associated with chemotherapy administration and other cutaneous diseases. Concentration of the chemotherapeutic agents is believed to effect toxic changes in these epithelial structures. We report the first case of vincristine‐induced eccrine squamous syringometaplasia in a 12‐year‐old patient undergoing treatment for rhabdomyosarcoma.     

Syringometaplasia: variants and underlying mechanisms

Syringometaplasia is an adaptive, benign, metaplastic cellular process that affects the eccrine ducts and glands in response to a variety of physiological or pathological stimuli. Different subtypes of syringometaplasia have been described, including the squamous, mucinous, and adenomatous types. These metaplastic changes have been reported in association with chemotherapeutic agents, as well as with a variety of skin disorders including multiple infectious, neoplastic, and inflammatory skin diseases. In this review, we attempt to shed light on the different patterns of syringometaplasia, its pathogenesis, the plethora of skin conditions in which it may be observed, and the differential diagnoses that should be considered.     

黏液性汗管化生

报告1例黏液性汗管化生。患者男,52岁。左足跟内侧外伤后出现丘疹10年。皮肤科检查:左足跟内侧一直经约0.8 cm的丘疹,表面有糜烂和轻度渗液。皮损组织病理检查:表皮不规则增生,局部可见腺腔样分化,并可见杯状细胞。PAS及阿新蓝染色示杯状细胞染色阳性。免疫组化染色结果示腺腔及杯状细胞Cam5.2、癌胚抗原(CEA)及上皮膜抗原(EMA)阳性。诊断:黏液性汗管化生。     

Mucinous nevus

A 15-year-old boy first noticed multiple firm papules on his right upper chest two years before presenting to our clinic. These papules were densely distributed and showed epidermal nevus-like linear arrangement at some sites. The number, size, and distribution of these papules remained unchanged for one year of our observation. The papules flattened leaving scars and did not recur within a year after one shaving abrasion using a scalpel. Histopathologically, epidermis of the papule displayed acanthosis with elongated rete ridges. Accumulation of mucin was apparent in the papillary and subpapillary dermis. In mucinous nevus, the origin of cells with nevoid proliferation is obscure. In contrast with common collagenous connective tissue nevus, it is hard to define the localized persistent mucin accumulation as a nevoid manifestation. The present case of mucinous nevus might be caused by significantly stimulated glycosaminoglycan synthesis in a kind of epidermal nevus without extreme hyperkeratosis.     

黏蛋白痣一例

患者,男,28岁。右侧腰部出现多发褐色丘疹、斑块10年。皮肤科查体：右侧腰腹部散在粟粒至蚕豆大褐色丘疹、斑块,部分融合成片。皮肤组织病理示：表皮角化过度伴角化不全、棘层肥厚,呈疣状增生,表皮突延长,有散在或小片状的淋巴细胞及组织细胞浸润。阿新兰染色阳性。诊断：黏蛋白痣。患者拒绝治疗。     

Mucinous eccrine nevus

A 46-year-old man with an erythematous, tender, swollen patch on the dorsum of his left fourth toe visited us. The biopsied tissue showed a proliferation of normally structured eccrine glands and ducts surrounded with abundant materials confirmed as mucin by toluidine blue stain. Mucinous eccrine nevus is an extremely rare entity, and only two cases have been reported in the literature. We describe a case of mucinous eccrine nevus which was late in onset and presented as a swollen patch.     

黏蛋白痣一例并文献复习

<正>临床资料患者,男,44岁。右股部外侧增生性斑块30余年。患者30余年前,右侧股部外侧无明显诱因出现褐色增生性斑块,皮损逐渐扩大,无明显自觉症状。既往体健,一般情况好。否认该部位的外伤史及类似疾病的家族史。皮肤科查体:右股部外侧散在大小不等、形状不规则的褐色增生性斑块、结节,质软,沿Blaschko线分布(图1,2)。皮肤镜检查:可见表面无明显鳞屑,增生物呈皮色,皮损间可见深沟纹及点球状凹陷,呈脑回样,凹陷处有灰褐色色素沉着(图3)。组     

Mucinous hidradenoma: a report of three cases

Mucinous cutaneous adnexal tumors are an uncommon occurrence. We describe three cases of mucinous hidradenoma characterized by diffuse and prominent mucinous cell proliferation and discuss the relevant literature. The patients (two men and one woman) ranged in age from 32 to 72 years. The lesions were completely excised, and all patients were alive without evidence of disease (follow-up interval 3-4 years). Case 1 presented as a 1.3-cm eyelid nodule and histology showed a mucinous apocrine hidradenoma with a proliferation of mucinous cells and apocrine glands. Case 2, from the shoulder of a 40-year-old man, was a 2.5-cm well-circumscribed nodule composed of hyperplastic villoglandular proliferation of mucinous cells with focal squamous whorls and focal columnar glandular cells showing decapitation secretion. The tumor was also interpretated as a mucinous hidradenoma, most likely of follicular-apocrine origin. Case 3 was a 3.0-cm scalp nodule. The histology showed a mucinous clear-cell hidradenoma composed of numerous mucinous glands amidst small squamous cells with clear cytoplasm and a hyalinized fibrovascular stroma.     

Mucinous eccrine naevus: case report and review of the literature

Mucinous eccrine naevus (MEN) is an extremely rare variant of eccrine naevus. There are only nine reported cases in the English literature. We report a 3‐month‐old boy with a congenital lesion on the lower back, and review the other cases in the literature. In most cases, MEN presents before puberty. The commonest presentation is a unilateral, solitary, brownish nodule without hyperhidrosis occurring on the legs. The diagnosis of this condition is confirmed by the characteristic histopathological features. Treatment options may be considered if symptomatic.     

Mucinous naevus with atypical features

Pseudoainhum is a term used to describe the presence of constricting bands of the extremities due to a variety of underlying causes. Progression of the lesions can cause irreversible damage and autoamputation of the affected digit. This report documents a rare association of pseudoainhum and psoriasis and emphasizes the importance of recognizing this condition.     

Giant Juvenile Xanthogranuloma: Exophytic and Endophytic Variants

Xanthogranulomas larger than 2 cm are rarely reported variants of this otherwise common, benign lesion usually measuring 1 mm to 1 cm in diameter. The natural history of such macronodular xanthogranulomas is uncertain, but appears to parallel the generally predictable course toward involution seen in micronodular lesions. Two patients with macronodular xanthogranuloma illustrate exophytic and endophytic variants, as well as the problems of managing this unusual tumor. Nonoperative observation is advisable if possible, but complicating factors may necessitate surgical excision in some cases.     

Mucinous eccrine nevus: an unusual lesion in a child

Mucinous eccrine nevus has been described as a variant of eccrine nevus. Only one instance of this variant, diagnosed in a 47-year-old woman, has been reported. We report a 2-year-old girl who had two 1 cm, asymptomatic, brownish nodules. Histologic analysis revealed a dermal lobulated proliferation of eccrine structures surrounded by a prominent mucinous stroma. This is thus, to the best of our knowledge, the first case of this extremely rare entity in a child.     

Mucinous carcinoma of the skin with apocrine-type differentiation: immunohistochemical studies

We investigated the pathway of differentiation in a case of mucinous carcinoma of the skin (MCS) arising on the right temple of a 70-year-old man. Histopathologic findings of the tumor showed evidence of apocrine-type differentiation such as distinctive decapitation secretion. Additionally, by employing a panel of antibodies, the immunohistochemical staining pattern of tumor cells was shown to be compatible with that of apocrine glands. Although the differentiation of this neoplasm remains controversial, the findings in our case suggest apocrine differentiation.     

Hereditary Progressive Mucinous Histiocytosis: New Insights Into a Rare Disease

Hereditary progressive mucinous histiocytosis is a rare, benign, skin‐limited form of non‐Langerhans cell histiocytosis. We report on a 5‐year‐old boy who presented in infancy with self‐resolving dermal nodules but later developed persistent and progressive erythematous papules on the face and scalp. Histologic evaluation revealed dermal aggregates of S‐100/CD1a‐negative histiocytes with abundant mucin. We present this case to highlight the evolution of the lesional morphology in infancy and early childhood and to stress the importance of histology in confirming this rare disorder.