• Title/Summary/Keyword: Skin Lesion Diagnosis

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Focal Adnexal Dysplasia in a Dog (개에서 Focal Adnexal Dysplasia 증례)

  • Park, Ho-Il;Hur, Won-Suk;Cho, Eun-Sang;Song, Sin-Hwa;Jeong, Seong-Mok;Cho, Sung-Whan;Son, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.26 no.3
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    • pp.259-262
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    • 2009
  • Focal adnexal dysplasia(FAD) is a rare non-neoplastic lesion of adnexal appendages that occurs in dogs and has good prognosis. We report a case in which FAD diagnosis was favored by its histopathological features. A 8-year-old, castrated male American cocker spaniel dog presented with papillomatous masses on the distal phalanx of left forelimb. Histopathologically, the stroma was sharply demarcated from the adjacent dermis and subcutis. The adnexa was surrounded and interspersed with abundant, hyalinized collagen and the numerous sebaceous lobules distributed haphazardly around hair follicles, which is thickened, dilated and tortuous with abundant keratin. Epidermis was acanthotic. Proliferative lesions of the skin region are very common with similar gross features, thus the basic histopathological examination supported by additional diagnostic methods allow to establish the definitive diagnosis in most cases of cutaneous tumor or tumor-like lesions. And it is important that physicians and pathologists are aware of this unusual tumour-like nonneoplastic lesion.

Perforating Granuloma Annulare Mimicking Papulonecrotic Tuberculid

  • Chae, Myeong Heon;Shin, Jee Yon;Lee, Ji Yeoun;Yoon, Tae Young
    • Annals of dermatology
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    • v.30 no.6
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    • pp.716-720
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    • 2018
  • Perforating granuloma annulare (PGA), a rare variant of granuloma annulare, is characterized by transepidermal elimination of altered collagen that clinically manifests an umbilicated papule with a central crust. It can be confused with papulonecrotic tuberculid (PNT) because of their similar appearance. Unlike PGA, PNT is usually related to tuberculosis infection with a typical histologic finding of wedgeshaped dermal necrosis. Here, we report the first Korean case of PGA mimicking PNT both clinically and histologically. A 43-year-old Korean woman presented with erythematous papules localized on the extensor surface of her limbs for one year. Some of these papules had a central umbilication or a crust. Regarding comorbidity, she had latent tuberculosis diagnosed with $QuantiFERON^{(R)}-TB$ Gold test about five months ago. She was on antituberculous medication. Initially, a diagnosis of papulonecrotic tuberculid accompanied by latent tuberculosis was considered. However, despite taking the antituberculous medication for five months, her skin lesions were not improved. Biopsy specimen from her arm lesion showed wedge-shaped area of necrosis in the dermis. Additionally, there were multiple focal mucin depositions and palisading granulomatous inflammation throughout the dermis. A diagnosis of PGA was made and she was treated with topical corticosteroid. After two weeks of applying topical corticosteroid, most of her skin lesions disappeared, leaving some hyperpigmented scars.

Development of seven secondary neoplasms in a nevus sebaceous: a case report and literature review

  • Kuo, Yi-Wen;Lin, Jung-Chia;Tsai, Wei-Hsuan
    • Archives of Craniofacial Surgery
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    • v.23 no.2
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    • pp.83-88
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    • 2022
  • Nevus sebaceous of Jadassohn is a congenital cutaneous hamartoma with epidermal, sebaceous, follicular, and apocrine structures that usually appears at birth or in early childhood. It has the potential to generate a variety of secondary neoplasms of different lineages, and the risk increases with patient age. Although multiple neoplasms may occasionally arise within the same lesion, the coexistence of more than five secondary tumors is extremely rare. Here we report a case of seven secondary tumors including syringocystadenoma papilliferum, desmoplastic trichilemmoma, sebaceoma, trichoblastoma, pigmented trichoblastoma, sebaceous adenoma, and tumor of follicular infundibulum arising within a nevus sebaceous. The complete diagnosis relies on the histopathological analysis of multipoint biopsies and delicate pathological sections.

Treatment of primary cutaneous anaplastic large cell lymphoma

  • Baik, Bong Soo;Lee, Wu Seop;Ji, So Young;Park, Ki Sung;Yang, Wan Suk;Kim, Sun Young
    • Archives of Craniofacial Surgery
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    • v.20 no.3
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    • pp.207-211
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    • 2019
  • Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a rare subtype of primary cutaneous lymphoma with a favorable prognosis. Primary cutaneous CD30+ lymphoproliferative disorders, which include C-ALCL and lymphomatoid papulosis, are the second most common group of cutaneous T-cell lymphomas. C-ALCL is comprised of large cells with anaplastic, pleomorphic, or immunoblastic cytomorphology, and indeed, more than 75% of the tumor cells express the CD30 antigen. C-ALCL clinically presents with solitary or localized reddish-brown nodules or tumors, and sometimes indurated papules, and they may be with ulceration covering with dark eschar. Multifocal lesions are seen in 20% of the patients. Extracutaneous dissemination, which mainly involves the regional lymph nodes, occurs in 10% of patients. A 69-year-old man noticed a mild elevated cutaneous lesion containing central ulceration covering with brownish black necrotic tissue on the right lower lip, and the lesion was surgically removed. After the first operation, another skin lesion was developed and the histological examination confirmed the diagnosis, C-ALCL. Eight specimens were excised during the 7-month follow-up period. The patient started the treatment with low-dose oral methotrexate (15 mg/wk) and there was no recurrence for 11 months.

Extracranial systemic antitumor response through the abscopal effect induced by brain radiation in a patient with metastatic melanoma

  • D'Andrea, Mark A.;Reddy, G.K.
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.302-308
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    • 2019
  • The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

Angiomyoma on Face : A Case Report (안면부에 발생한 혈관근종의 치험례 : 증례보고)

  • Choi, Junho;Chang, Hak
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.48-50
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    • 2013
  • Angiomyoma is a rare, benign smooth muscle cell tumor. These tumors may be found anywhere in the body. They frequently occur in the lower extremities except venous type. Angiomyoma in the head and neck area is very rare, and only a few cases have been reported. A 63 year-old male patient visited to outpatient clinic due to size-growing nodule-like lesion in the Lt. alar area. Excisional biopsy was done for diagnosis. The lesion was totally excised with 2 mm safety margin. Frozen biopsy of the lesion was requested, and all resection margins were proved negative. To cover the raw surface, full thickness skin grafting was performed. The graft was harvested from Rt. posterior auricular area. Tie over dressing was applyed on Lt. alar area. The graft was well taken and healed without any complication in both short term and long term follow up periods of 2 weeks, 1 month, 2 months, and 6 months. Donor site completed healed without any complications. The leiomyoma is benign tumor originated from smooth muscle, and it can be classified into solid leiomyoma, angiomyoma, and epithelioid leiomyoma. Especially, the angiomyoma consists of smooth muscle cell and blood vessel, and it is originated from the tunica media of blood vessel. Angiomyoma alone frequently occurs in the lower extremities as solitary painless subcutaneous tumor. Venous type of angiomyoma in the oral cavity was reported in other references, but on the facial surface it may be the first case reported as paper. So this report can be very meaningful.

A Method for Observation of Benign, Premalignant and Malignant Changes in Clinical Skin Tissue Samples via FT -IR Microspectroscopy

  • Skrebova, Natalja;Aizawa, Katsuo;Ozaki, Yukihiro;Arase, Seiji
    • Journal of Photoscience
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    • v.9 no.2
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    • pp.457-459
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    • 2002
  • Sunlight causes various types of adverse skin changes on the sun-exposed areas of the skin, in which the most hazardous one is the induction of malignant skin tumours. FT -IR spectra were obtained from specimens excised from normal skin, BCCs, SCCs, MMs, nevi, lesions of solar keratosis and Bowen's disease. Tissue samples from freshly frozen specimens were cut into 2 sections in strictly sequential order to be stained with H & E for histopathological analysis, and then to be air-dried on CaF$_2$ slide glasses for further spectral data acquisition from defined area of interest. Intra- and inter-sample variations were estimated within grouped lesion categories according to each skin component. Mean spectra for each type of tissue pathology in the 800-1800 $cm^{-1}$ / region was interpreted using the classical group frequency approach that showed the most visible differences in spectra of benign, premalignant and malignant changes directly related to protein conformation and nucleic acid bases. The relative intensity of the nucleic acid peak was increased with progression to malignancy. In addition, PCA was able to evaluate and maximise the differences in the spectra by reducing the number of variables characterizing each patient and pathology category. This type of approach to non-destructively estimate the complexity of IR-spectra of inhomogeneous samples such as skin demonstrates the advantage of FT -IR microspectroscopy to be able to observe diseased states (benign, premalignant, malignant) and distinguish them from normal against a huge background of inter- and intra-subject variability.

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Iatrogenic epidermoid cyst in the parotid gland: A case report (이하선에서 발견된 유표피낭: 증례 보고)

  • Lee, Choong-Sang;Kim, Hyoung-Keun;Lim, Jae-Hyung;Jeon, Kug-Jin;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.237-240
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    • 2011
  • Epidermoid cysts presents as a nodular and fluctuant subcutaneous lesion beneath the skin and are most common in acne-prone areas of the head, neck and back. This cyst often arises after localized inflammation of the hair follicle and occasionally after the implantation of epithelium following trauma and surgery including a biopsy procedure. It is often associated with Gardner syndrome, particularly before puberty. The lesion is normally treated by a surgical excision or enucleation, and recurrence is uncommon. A 27 year old woman complained of a swelling of the left parotid gland when she visited our clinic. A cystic lesion was found in the left parotid gland from the high signal intensity on the MR images. Ultrasonography showed that the cystic lesion was heterogeneous echogenic. Six months earlier, botulinum toxin was injected in her left masseter muscles six months earlier and progressive swelling of the left parotid area was noticed four months after treatment. The lesion was surgically removed. It was encapsulated by a thin wall and filled mainly with keratin. The final diagnosis was an epidermoid cyst.

Erythema Multiforme and Stevens-Johnson Syndrome : Case Reports (다형홍반과 스티븐스-존슨 신드롬의 증례보고)

  • Jung, Won;Lee, Kyung-Eun;Byun, Jin-Seok;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.36 no.4
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    • pp.207-213
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    • 2011
  • Painful, ulcerative lesions of various systemic disease can affect the oral mucosa membrane at first. If you don't consider the skin lesion, followed or accompanied by oral mucosa, you are likely to fail in differential diagnosis. In this cases, we introduced erythema multiforme and Stevens-Johnson syndrome(SJS) patients with painful, ulcerative lesions on oral mucosa and skin. Also we review oral mucosal diseases come with the skin lesions.

Multiple Myopericytoma of the Face and Parotid Gland

  • Jung, Yun-Ik;Chung, Yoon-Kyu;Chung, Seum
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.158-161
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    • 2012
  • Myopericytoma is a benign tumor that is composed of myoid-appearing oval to spindle-shaped cells with a concentric perivascular pattern of growth. The tumor is morphologically heterogeneous and can exhibit a broad histologic spectrum. We describe a case of multiple myopericytoma occurring in the head and neck skin region with involvement of the parotid gland where it is known to occur very rarely. A 40-year-old woman noticed multiple enlarging, painless, round-shaped masses on her left cheek. The patient had experienced a similar lesion of the same area 8 years earlier which was completely excised and the pathological diagnosis was spindle cell type myoepithelioma. On a computed tomographic image, one mass involved the superficial parotid gland and was well encapsulated. Excision of the facial masses and superficial parotidectomy with facial nerve preservation were performed. A diagnosis of myopericytoma was established in light of the immunohistochemical pattern with the histopathological findings. Over the 4-year follow-up period, there was no evidence of recurrence. As many perivascular myoid neoplasms share common morphologic features with myopericytoma, we should consider the differential diagnosis, and confirm the histological findings with appropriate immunohistochemical staining. After identifying myopericytoma, it should be treated with wide surgical excision to prevent local recurrence.