Atrophic dermatofibrosarcoma protuberans

A 48-year-old woman presented with a 20-year history of an asymptomatic depressed atrophic plaque on the abdomen. Five years earlier a punch biopsy of the same lesion had been carried out and a diagnosis of dermatofibroma was made. She was reassured and discharged. Further consultation was sought due to extension and thickening of the lesion. Re-examination of the initial and new incisional biopsy specimens, along with histochemical staining for CD34, established the diagnosis of atrophic dermatofibrosarcoma protuberans. A wide local excision was carried out. There has been no recurrence at 9 months of follow up.     

Dermatofibroma with Myxoid Changes in a Patient with Psoriasis

A 38-year-old female with psoriatic arthritis developed a dermatofibroma (DF) on her upper arm. Its position was not exactly on a psoriatic plaque; however, psoriatic lesions were present diffusely around the DF lesion. Histological examination revealed the typical features of DF with myxoid changes in the portion between the tumor nest and the overlying epidermis. The mast cell number was significantly increased over that of solitary DFs without myxomatous lesions. It was suggested that mast cells may play a role in induction of the myxoid changes in the DF lesion in this case.     

Mycosis fungoides exhibiting features of a dermatofibroma: a case report and review of the literature

We present the case of a 60-year-old male with known stage IA mycosis fungoides (MF) who developed a suspicious tumor within a pre-existing lymphomatous plaque of the right forearm. Microscopy revealed an unusual mixed fibrohistiocytic proliferation as well as atypical intraepidermal and dermal lymphocytes. There was no evidence of large-cell transformation. Histopathological, immunohistochemical and clinical clues suggest this lesion might not have represented a dermatofibroma, but rather a hitherto unreported dermatofibroma-like process arising within a lesion of MF. The potential impact of this atypical lesion on the prognosis and clinical management of this patient highlights the importance of recognizing unusual clinical presentations of more common, benign lesions within this patient population.     

Plaque‐like dermatofibroma: A distinct and rare benign neoplasm?

Unusual large dermatofibromata are reported in a 40-year-old man and a 48-year-old man, who both presented with plaques on a lower limb. The largest plaque in each case was well-defined, reddish brown, indurated and measured 50 mm x 30 mm and 70 mm x 40 mm, respectively. Several satellite lesions were present around the large plaques. Dermoscopic examination showed diffuse homogenous pigmentation in the absence of other diagnostic criteria for dermatofibroma. Light microscopy of biopsies from each patient displayed similar features. There was a dermal proliferation of fibrohistiocytic cells that entrapped intervening thickened collagen fibres. The overlying epidermis was acanthotic, and in some instances this showed basal hyperpigmentation. There was no evidence of malignancy. Immunohistochemical staining was positive for Factor XIIIa and negative for CD34. Based on the histological findings, a diagnosis of dermatofibroma was made for each of these cases. Fewer than 20 adult cases of large dermatofibroma of this scale, designated giant dermatofibroma, have been reported to date; and only two have shown a plaque-like appearance, the remainder being pedunculated. The authors propose plaque-like dermatofibroma as a variety of large dermatofibroma distinct to pedunculated giant dermatofibroma.     

Multiple eruptive myxoid dermatofibromas: report of first case and review of literature

Multiple eruptive dermatofibromas are a rare presentation of dermatofibroma which are frequently associated with underlying diseases such as human immunodeficiency virus infection or lupus erythematosus. Eruptive dermatofibromas generally present a characteristic histology with a poorly circumscribed lesion showing hyperplasia of the epidermis, prominent bundles of collagen and a diffuse proliferation of fibrocytes. We report an unusual case of multiple eruptive dermatofibromas showing massive depositions of mucin within the dermis. A 20-year-old woman presented with nearly 100 red to yellowish papules and nodules distributed symmetrically all over the integument which developed over a period of 9 years. Comprehensive clinical and laboratory diagnostics showed no signs indicating any underlying disease. To our knowledge this is the first report of multiple eruptive myxoid dermatofibromas. We consider this case to be a unique presentation of multiple eruptive dermatofibroma showing massive deposition of mucin.     

Homogeneous blue pigmentation in dermatofibroma simulating a blue naevus

A case with a pigmented skin lesion that was diagnosed as a blue naevus on clinical and dermoscopic grounds and histopathologically confirmed as a dermatofibroma is presented. By means of this case, we define dermatofibroma as a new exception for 'homogeneous blue pigmentation' on dermoscopy.     

Atrophic dermatofibroma

Atrophic dermatofibroma, a newly proposed entity in recent times, is thought to be a specific variant of dermatofibroma. We report a typical case of atrophic dermatofibroma on the thigh of a 69-year-old female. The lesion consisted clinically of a light brown, intracutaneous nodule with a central crateriform depression, and histologically of fibrohistiocytic components in the thinning dermis. On elastica van Gieson stain, loss of elastic fibres and dense accumulation of elastic fibres around medium-sized vessels were observed in the lesion.     

足背皮肤纤维瘤病1例

患者女,36岁。双足背褐色斑块18个月。否认外伤史。皮肤科检查:左右足背见约3 cm×3cm和2 cm×2 cm褐色斑块,无压痛。皮肤组织病理示:表皮未见明显并常,真皮中下部可见肿瘤团块,由成纤维细胞及胶原柬组成,细胞无异型。诊断:皮肤纤维瘤病。     

Spontaneous regression of perianal extramammary Paget's disease after partial surgical excision

A 62-year-old woman presented with a three-year history of a pruritic perianal lesion, which was histologically confirmed to be perianal extramammary Paget's disease. Partial surgical excision of the lesion was followed by complete spontaneous regression of the residual plaque.     

Occult Basal Cell Carcinoma Arising in Seborrheic Keratosis

The present study reports a case of an occult basal cell carcinoma that arose in seborrheic keratosis. The patient was a fifty-six-year-old male who presented with a dark brown plaque on his back. Clinically, the lesion demonstrated no nodules or ulcerations suggesting that it was malignant. However, histopathological analysis of the lesion revealed an atypical basaloid cell mass that appeared to be a solid basal cell carcinoma beneath and surrounded by a seborrheic keratosis lesion. Thus, the coexistence of basal cell carcinoma and seborrheic keratosis is possible and should be considered when a malignant change in seborrheic keratosis is apparent.     

Localized hair follicle hamartoma

A 4-year-old male presented with an indurated papular plaque on his right nasolabial fold. The lesion, present since the child was a few months of age, progressively extended in a band-like fashion up to the upper lip. Microscopically, there was almost complete replacement of the hair follicles by trichoepithelioma-like epithelial proliferations associated with hyperplastic sebaceous glands. We interpret this lesion as a localized form of the clinicopathological entity known as generalized hair follicle hamartoma.     

Syringoid eccrine carcinoma with apparently aggressive transformation: case report and review of the literature

A 65‐year‐old man presented with a 20‐year history of a lesion on his lower abdomen. The lesion had started as an indolent papule that slowly developed to form an extensive plaque. Physical examination revealed a flat‐topped, elevated, well‐demarcated, erythematous plaque measuring 7 cm × 5 cm in diameter ( Fig. 1 ). The lesion had an elastic, hard induration beneath the plaque and was fixed to the underlying tissue. Inguinal lymphadenopathy was present. Hematologic and biochemical investigations were all within the normal ranges. The patient underwent incision biopsy.

Figure 1 Open in figure viewer PowerPoint Clinical appearance of the lesion. An indurated plaque can be seen on the lower abdomen     

Sporotrichosis on the Face of a 7‐Year‐Old Boy Following a Bicycle Accident

Abstract: A 7‐year‐old boy presented with an annular verrucous plaque on the chin of 5 weeks duration. The lesion occurred after a bicycle accident and was unresponsive to antibiotics. Fungal culture grew Sporothrix schenckii. Sporotrichosis should be considered and fungal culture obtained whenever a nodule or plaque fails to respond to initial treatment.     

Dermatofibrosarcoma protuberans: an early non-protuberant phase of the tumour

A 40-year-old female patient presented with a flat scar like plaque on the upper chest. The patient's perception of subtle change in the lesion was of paramount importance in the decision to biopsy this lesion of innocuous clinical appearance. Histopathological findings were those of dermatofibrosarcoma protuberans. This case illustrates the early clinical features of the tumour and a recommendation for taking a biopsy of any scar-like plaque where there is no clear history of preceding trauma.     

Topical calcipotriol ointment in the treatment of morphea

A 5-year-old girl presented with a 2-month history of an indurated hypopigmented, atrophic plaque of biopsy-documented morphea over the right hip area. Previous treatment with 0,1% betamethasone valerate cream twice a day for 3 months failed to improve the lesion. She was treated with calcipotriol ointment twice daily, with nightly occlusion to the plaque for 9 months, and this resulted in resolution. No side effects were noted.     

多发性皮肤鳞状细胞癌1例

患者男,82岁。左胫前皮肤局限性斑块伴痒20余年,结节破溃两年。患者20余年前左胫前出现一局限性斑块,表面有鳞屑,伴瘙痒,外院以"神经性皮炎"予外用药物及局部封闭治疗,皮损未消退。后反复搔抓刺激,搔抓后破溃、结痂,逐渐相继形成两个结节。未发现全身其他器官转移。皮损组织病理示:两结节均显著角化过度,角化不全,浅表糜烂、结痂,真皮内可见鳞状上皮岛伴中央角化,边缘少量异型细胞,病理性核分裂相多见,可见角珠形成。诊断:多发性皮肤鳞状细胞癌。     

黏液性皮肤纤维瘤

报告1例黏液性皮肤纤维瘤.患者女,43岁.右前臂丘疹2周余.皮肤科检查:右前臂一直径约0.8 cm结节.组织病理检查示表皮不规则增生,真皮内可见大量梭形细胞增生,局部胶原排列疏松,阿新蓝染色阳性.免疫组化染色结果示波形蛋白(vimentin)阳性,CD31、CD34、平滑肌肌动蛋白(SMA)和S-100蛋白阴性.诊断为黏液性皮肤纤维瘤.     

ILVEN-like persistent psoriasiform dermatitis confined to a congenital Becker nevus

Abstract:  A 10-year-old boy presented with a 5-year history of an intractably pruritic, recalcitrant psoriasiform plaque in a broad vertical band on the left buttock, with histologic as well as clinical features suggestive of an inflammatory linear verrucous epidermal nevus. This lesion was completely superimposed upon a congenital Becker nevus. We postulate that the restricted distribution and persistence of the psoriasiform plaque reflected an inflammatory response limited to the aberrant clone of cells composing the Becker nevus, a manifestation of cutaneous mosaicism that could be characterized as an "inflammatory Becker nevus."     

Lymphoplasmacytic plaque in children: a report of two new cases with review of the literature

Lymphoplasmacytic plaque in children has been proposed as a rare, emerging clinicopathologic entity characterized by solitary, extratruncal, asymptomatic papules and plaques that are typically found in healthy young Caucasian females. Biopsy of these lesions reveals a dermal lymphoplasmacytic infiltrate with or without epithelioid granulomas. Two unique patients with lymphoplasmacytic plaque in children are presented in this report, including a 26‐month‐old female with a lesion on her finger, who represents both the youngest described patient and the first documented with a finger lesion, as well as a 17‐year‐old young woman with a left thigh lesion, who represents the patient with the longest clinically and histopathologically observed lesion to date. These two additional patients corroborate the experience of lymphoplasmacytic plaque in children in the six previously reported cases and further expand the clinicopathologic spectrum of the disease. Recognition of lymphoplasmacytic plaque in children is important to facilitate distinction from potential differential considerations, including lymphoproliferative disorders and infectious conditions, particularly as the experience to date appears to suggest that lymphoplasmacytic plaque in children represent a reactive (pseudolymphomatous) condition.     

Case of dystrophic calcinosis cutis in epidermal cyst arising from verrucous epidermal nevus

Dystrophic calcinosis cutis is diagnosed when calcium is deposited into previously damaged tissue by connective tissue disease, panniculitis, pseudoxanthoma elasticum or trauma. We report a case of dystrophic calcinosis cutis arising from the lesion of an epidermal cyst on the verrucous epidermal nevus. A 20‐year‐old woman presented with a polypoid pinkish tumor on a brownish, verrucous plaque. Histopathological findings of the pinkish tumor showed calcium deposits as amorphous, basophilic material lining the true epidermis in the upper dermis, which were compatible with dystrophic calcinosis cutis and the plaque was diagnosed as a verrucous epidermal nevus.