Seborrheic Keratosis Research Articles

Multiple-lesion, non-familial basal cell carcinoma-An interesting oddity

Basal cell carcinoma (BCC) is the most common primary carcinoma of skin, which accounts for three-fourth of all primary skin tumours. Basal carcinoma occurs commonly as a single lesion, though occasionally it can occur as Multiple lesions, which may occur in close association with heredofamilial conditions such as nevoid basal cell carcinoma syndrome (Gorlin’s syndrome), Bazex syndrome, Rombo syndrome, and unilateral basal cell nevus syndrome. The case of multiple basal cell carcinomas being presented here is unique in its occurrence inasmuch as it is not associated with heredofamilial conditions, and despite not being associated with heredofamilial conditions there is occurrence of multiple basal carcinomas in a patient in a tertiary care hospital in a dominantly tribal region. The patient has no family history of genodermatosis that could increase the incidence of multiple basal cell carcinomas such as xeroderma pigmentosum, and no history of other predisposing conditions including actinic keratosis, Bowen’s Disease, leukoplakia, Erythroplasia of Queyrat, keratoacanthoma, radiation dermatitis and exposure to arsenicals, psoralen and other photosensitizing medications. However, the patient had history of having raised macules over the face which were diagnosed as seborrheic keratosis.

Melanoacanthoma – A Diagnostic Dilemma

Melanoacanthoma (MA) is an uncommon benign tumour confined to the epidermis. It is formed by aggregation of pigment-producing melanocytes and keratinocytes. It is a close differential of melanoma and hence has to be evaluated in detail. Here, we present a case of MA over the scalp along with its clinical and dermoscopic description.

Dermoscopy of Lentiginous Melanomas and Equivocal Benign Pigmented Macules of the Scalp: A Case-Control Multicentric Study

Introduction: Although the dermoscopic features of facial lentiginous melanomas (LM), including lentigo maligna and lentigo maligna melanoma, have been extensively studied, the literature about those located on the scalp is scarce. This study aims to describe the dermoscopic features of scalp LM and assess the diagnostic accuracy of dermoscopy to discriminate them from equivocal benign pigmented macules. Methods: Consecutive cases of scalp LM and histopathology-proven benign but clinically equivocal pigmented macules (actinic keratoses, solar lentigos, seborrhoeic keratoses, and lichen planus-like keratoses) from four referral centres were included. Dermoscopic features were analysed by two blinded experts. The diagnostic performance of a predictive model was assessed. Results: 56 LM and 44 controls were included. Multiple features previously described for facial and extrafacial LM were frequently identified in both groups. Expert’s sensitivity to diagnose scalp LM was 76.8% (63.6–87.0) and 78.6% (65.6–88.4), with specificity of 54.5% (38.9–69.6) and 56.8% (41.0–71.7), and fair agreement (kappa coefficient 0.248). The strongest independent predictors of malignancy were (OR, 95% CI) chaos of colour (15.43, 1.48–160.3), pigmented reticular lines (14.96, 1.68–132.9), increased density of vascular network (3.45, 1.09–10.92), and perifollicular grey circles (2.89, 0.96–8.67). The predictive model achieved 85.7% (73.8–93.6) sensitivity, 61.4% (45.5–75.6) specificity, and 81.5 (73.0–90.0) area under curve to discriminate benign and malignant lesions. A diagnostic flowchart was proposed, which should improve the diagnostic performance of dermoscopy. Conclusion: Both facial and extrafacial dermoscopic patterns can be identified in scalp LM, with considerable overlap with benign pigmented macules, leading to low specificity and interobserver agreement on dermoscopy.

Algorithm of prognosis of psychological adaptation-maladaptationas the basis of personalized psycho-correction of patients with dermatological diseases with different levels of vital threat

Purpose: to substantiate the algorithm for predicting the state of psychological adaptation - maladaptation of patients with dermatological pathology with different levels of vital threat, on the basis of which to develop personalized psychocorrection programs for this contingent, and to evaluate the effectiveness of their implementation. .
 Contingent and research methods. Based on the principles of biomedical ethics and deontology, we comprehensively examined 120 dermatological patients who were treated in three branches of the clinic "Dr. Zapolska Clinic" during 2020-2022, namely: 60 patients with non-vital dermatological diseases (seborrheic keratosis L82, condylomas A63.0, angiomas D18.0, pigmentation disorders L80), and 60 patients with dermatological diseases posing a vital threat ( melanoma C43, basal cell carcinoma C44, skin carcinoma in situ D04).
 Results. Among patients with dermatological diseases, there are both psychologically adapted and maladapted individuals, regardless of the vitality/non-vitality of the pathological process.
 The process of formation of psychological maladaptation in patients with dermatological diseases with different levels of vital threat does not have nosospecificity, but depends on the initial state of the adaptive resource base of the individual, first of all, its psychosocial and individual-psychological components.
 Summarizing the obtained results made it possible to identify three main blocks of characteristics that cover a wide range of biological, individual-psychological, social-environmental and psychosocial factors, which we defined as factors/markers of psychological adaptation-maladaptation in patients with dermatological diseases with different levels of vital threat: psychoemotional , psychosocial and personal.
 Based on the analysis of determined markers of psychological adaptation-maladaptation using mathematical methods, an algorithm for assessing and predicting psychological maladaptation in this contingent of patients is proposed.
 This algorithm determines the criteria of personification, the structure and scope of developed psychocorrective measures at different degrees of risk of psychological maladaptation in patients with dermatological diseases with different levels of vital threat.
 A three-stage system of psychocorrective interventions (assessment-diagnostic, clinical-therapeutic, and correction-adaptation stages) has been developed, united by the complexity and continuity of correction, psychotherapeutic, and adaptation measures. At the assessment-diagnostic stage, the prognosis of the development and progression of maladaptation is assessed, which ensures the personification of psychocorrective interventions, which are carried out mainly at the clinical-therapeutic stage, the positive effect of which is fixed at the last, corrective-adaptation stage.
 The evaluation of the effectiveness of these measures proved their effectiveness in eliminating psychopathological manifestations (depression and anxiety), improving the quality of life and social functioning, and increasing vitality and resilience.
 Conclusion. Personalized psychocorrection of patients of dermatological practice with different levels of psychological maladaptation may be recommended for the introduction into health care practice.

Epidemiologic Profile of Seborrheic Keratosis and Acrochordon at the National Referral Hospital in Indonesia

Epidemiologic Profile of Seborrheic Keratosis and Acrochordon at the National Referral Hospital in Indonesia

Melanoma clinicopathological groups characterized and compared with dermoscopy and reflectance confocal microscopy

Dermoscopic and reflectance confocal microscopy (RCM) correlations between morphologic groups of melanoma have not yet been described. Describe and compare dermoscopic and RCM features of cutaneous melanomas with histopathological confirmation. Single center, retrospective analysis of consecutive melanomas evaluated with RCM (2015-2019). Lesions were clinically classified as typical, nevus-like, amelanotic/nonmelanoma skin cancer (NMSC)-like, seborrheic keratosis (SK)-like and lentigo/lentigo maligna (LM)-like. Presence or absence of common facial and nonfacial melanoma dermoscopic and RCM patterns were recorded. Clusters were compared with typical lesions by multivariate logistic regression. Among 583 melanoma lesions, significant differences between clusters were evident (compared to typical lesions). Observation of dermoscopic features (>50% of lesions) in amelanotic/NMSC-like lesions consistently displayed 3 patterns (atypical network, atypical vascular pattern+regression structures), and nevus-like and SK-like lesions and lentigo/LM-like lesions consistently displayed 2 patterns (atypical network+regression structures, and nonevident follicles+heavy pigmentation intensity). Differences were less evident with RCM, as almost all lesions were consistent with melanoma diagnosis. Small SK-like lesions sample, single RCM analyses (no reproduction of outcome). RCM has the potential to augment our ability to consistently and accurately diagnose melanoma independently of clinical and dermoscopic features.

Deep learning based histological classification of adnex tumors

BackgroundCutaneous adnexal tumors are a diverse group of tumors arising from structures of the hair appendages. Although often benign, malignant entities occur which can metastasize and lead to patients´ death. Correct diagnosis is critical to ensure optimal treatment and best possible patient outcome. Artificial intelligence (AI) in the form of deep neural networks has recently shown enormous potential in the field of medicine including pathology, where we and others have found common cutaneous tumors can be detected with high sensitivity and specificity. To become a widely applied tool, AI approaches will also need to reliably detect and distinguish less common tumor entities including the diverse group of cutaneous adnexal tumors. MethodsTo assess the potential of AI to recognize cutaneous adnexal tumors, we selected a diverse set of these entities from five German centers. The algorithm was trained with samples from four centers and then tested on slides from the fifth center. ResultsThe neural network was able to differentiate 14 different cutaneous adnexal tumors and distinguish them from more common cutaneous tumors (i.e. basal cell carcinoma and seborrheic keratosis). The total accuracy on the test set for classifying 248 samples into these 16 diagnoses was 89.92 %. Our findings support AI can distinguish rare tumors, for morphologically distinct entities even with very limited case numbers (< 50) for training. ConclusionThis study further underlines the enormous potential of AI in pathology which could become a standard tool to aid pathologists in routine diagnostics in the foreseeable future. The final diagnostic responsibility will remain with the pathologist.

Clinical and histopathological characteristics, diagnosis and treatment, and comorbidities of Bowen's disease: a retrospective study.

Bowen's disease (BD) is a slow-growing precancerous skin condition, often concurrent with other diseases, with a high misdiagnosis rate. Previous studies show that patients with BD in different populations have differentiated characteristics. A retrospective study was conducted in a tertiary hospital in Shenzhen, China. Data about demographic information, diagnosis and treatment, clinical and pathological characteristics, and comorbidities of 50 patients with BD were collected and analyzed. Clinical data of onset age and disease course of 43 patients with BD were available, the average onset age of male and female patients are 55.1 (standard deviation (SD) = 15.29) and 58.2 (SD = 15.59) years old, respectively; the average disease course of male and female patients are 25.3 (SD = 28.63) and 33.9 (SD = 49.65) months, respectively. The onset age (p = 0.52) and disease course (p = 0.49) between male and female patients are not significantly different. Interestingly, there is a negative correlation between onset age and disease course (r = -0.245, p = 0.11). The correct rate of clinical diagnosis is relatively low (54.00%); Some patients with BD are misdiagnosed as Bowenoid papulosis (10.00%), actinic keratosis (8.00%), basal cell carcinoma (8.00%), seborrheic keratosis (6.00%), and pigmented naevus (4.00%). Trunk and limbs are the most common distribution sites of BD lesions, and 94.00% patients with BD are treated with surgical resection; 66.00% patients with BD had comorbidities, including skin diseases (48.48%), cardiovascular diseases (39.39%), gastrointestinal diseases (30.30%), respiratory diseases (27.27%), and tumors (18.18%). The most commonly observed histopathological characteristics of BD are squamous-cell hyperplasia (86.00%), disordered maturation with atypical keratinocytes (74.00%), atypical mitoses (60.00%), hyperkeratosis with hypokeratosis (48.00%), dermal inflammatory cell infiltration (36.00%), and koilocytosis (22.00%). BD often occurs in middle-aged and elderly people and is easily misdiagnosed. The onset age and disease course of patients with BD are not significantly different between males and females, whereas there is a negative correlation between the onset age and disease course. BD is more likely to occur in trunk and limbs in the Chinese population, and most patients with BD are concurrent with comorbidities.

Clinical and Dermatoscopic Features of Seborrheic Keratoses According to Skin Types: A Retrospective Study.

Seborrheic keratoses (SK), are very common benign skin lesions, which may increase in number and size with age. The aim of the study was to assess any differences seen in seborrheic keratoses in relation to different skin types (ST) and lesion location. This was a retrospective observational study of 10-months period, based on dermoscopic images of seborrheic keratoses and patient history recorded in database. Patients were categorized according to their age, sex, skin type, and location of SK. The frequency of SK remained high on the back for skin type 1, 2, 3 and 4. This same trend was also seen on the face and chest. In skin type 3 we saw a reversal of distribution of SK, the highest frequency remained on the back, and this was followed by the chest rather than the face. In skin type 5 and 6, the nature of the distribution of SK was more facial, CONCLUSIONS: In summary our study shows that SK are more commonly seen in males than in females, they tend to dominate in sun exposed sites especially the back and the face. Both the smaller and larger sized SK dominated in ST 1 and 2. The lighter to darker shades of color seen in seborrheic keratoses varied in accordance with the skin type, with lighter colored SK being seen more in lighter skin types as compared to darker skin types, whereas bluish colored SK were seen in all skin types except ST 1.

Epidemiology of Dermatologic Conditions Among Elderly Patients at the Ambulatory Care Service of a Tertiary Hospital in Metro Manila from 2014 to 2018: A Five-year Review

Introduction: Ageing is a progressive degenerative process that leads to decline in the physiological function and reserve capacity of the whole body system, including the skin. As the Filipino geriatric population escalates, the incidence of skin diseases becomes more widely acknowledged. Presently, there are only a few studies that have been reported locally describing the nature of geriatric dermatoses. Objectives: To describe the epidemiology of dermatologic conditions among Filipino elderly patients that prompted a consult at the ambulatory care service of a tertiary hospital between the years 2014 and 2018. Methodology: All Filipino elderly patients with dermatological conditions seen at the dermatology ambulatory care service from 2014 to 2018 was studied through a single-center, retrospective, descriptive study. Results: Elderly patients comprised 16.76% of the total patients who sought dermatological consultation at the ambulatory care service of the hospital. Majority of the patients were females. Xerosis/xerotic eczema (10.02%) was the most frequently encountered skin disease. The top 10 diseases were irritant contact dermatitis (7.00%), lichen simplex chronicus (6.67%), psoriasis (5.56%), seborrheic dermatitis (5.24%), allergic contact dermatitis (4.37%), tinea pedis (3.51%), herpes zoster (3.49%), seborrheic keratosis (3.23%), and milia (2.54%). Based on the nature of disease, inflammatory condition was the most commonly seen. Conclusion: Dermatological disorders are ubiquitous in older people with a significant impact on the quality of life. Inflammatory dermatoses comprise a wide array of skin diseases as evidenced in this study, which account for most of the cutaneous problems in the elderly. Similar to other epidemiological studies, xerosis/xerotic eczema still comprises majority of the cases prompting elderly patients to seek a dermatological consultation. Keywords: elderly, geriatric, dermatologic diseases, ambulatory, epidemiology

Dermoscopic Diagnosis of a Non-Pigmented Skin Tumor: Eccrine Poroma

Dear Editor, Eccrine poroma stands as a benign adnexal neoplasm that originates from the acrosyringium. It typically emerges as solitary, flesh-colored, or erythematous papules, plaques, or nodules, primarily appearing in areas with sweat glands. As well as pigmented lesions, dermoscopy has proven to enhance the clinical diagnosis of numerous non-pigmented skin tumors, including eccrine poroma. Herein we present a case of eccrine poroma located on the dorsal aspect of the left foot, with characteristic dermoscopic features. A 60-year-old woman was admitted with an asymptomatic lesion on the dorsum of her left foot, which had manifested approximately four years before. Clinically, the lesion presented as a well-circumscribed, violaceous, 0.9x0.9 cm papule (Figure 1a). Dermoscopic examination revealed flower-like and leaf-like vascular patterns, white interlacing areas, glomerular vessels, and milky red globules (Figures 1c-d). The lesion was excised and histopathologic findings were consistent with eccrine poroma (Figure 1b). Eccrine poroma (EP) is an adnexal tumor originating in the intraepidermal part of the eccrine sweat gland duct. Dermoscopy and histopathology help to differentiate EP from pyogenic granuloma, seborrheic keratosis, verruca vulgaris, basal cell carcinoma, squamous cell carcinoma, and amelanotic melanoma. Well-defined dermoscopic features in EP are: White interlacing areas around vessels, milky-red globules, flower-like and leaf-like vascular patterns, glomerular vessels, hairpin vessels, yellow structureless areas, poorly visualized vessels, and well-circumscribed globular or lacuna-like structures separated by white to pink mesh bands [1-3]. Histologically, EP manifests as a well-contained tumor constituted of proliferative cuboidal or poroid cells, often extending from the basal epidermis into the dermal layer. Shave, electrosurgical destruction or simple excision may be the treatment of lesions, depending on the depth of the lesion. Kind Regards

Impact of non-venereal genital dermatoses among female patients on the quality of life in a tertiary care center

Nonvenereal dermatoses of female external genitalia are genital diseases that are not transferred sexually and have a variety of etiologies. A prospective, observational study of adult female patients with nonvenereal dermatoses was conducted. A complete history and dermatological examination were performed, with skin biopsy in a few cases to aid in diagnosis. The data was collected and analyzed. During the course of this study, 82 cases of nonvenereal genital dermatoses were encountered. This study found that the most common age group was 20 to 45 years old [56%]. The most common presenting complaint was itching. In 42% of instances, fungal infections such as tinea cruris, vulval candidiasis, and scabies were identified. Lichen sclerosus et atrophicus, lichen simplex chronicus, contact dermatitis, vitiligo, psoriasis, seborrheic keratosis, and pemphigus vulgaris are among the other dermatoses identified. The Finlay dermatological life quality index (DLQI) questionnaire was used to assess the influence on patients' quality of life. Inflammatory illnesses such as lichen simplex chronicus lichen sclerosus et atrophicus, pemphigus vulgaris, psoriasis, hidradenitis suppurativa, and vitiligo reduced their quality of life moderately to severely.

Unstable solar lentigo mimicking lentigo maligna melanoma: A case report

Solar lentigo (SL) is a hyperpigmented macule that develops due to chronic ultraviolet exposure. A 35-year-old housewife, presented with an asymptomatic pigmented patch on the right side of her nose for the last 10 years, with a rapid increase in size and variability in pigmentation over the last 3 years. She had no history of excessive sun exposure. Upon examination, there was a solitary, hyperpigmented, well to ill-defined patch of irregular shape and margin, measuring 3 cm * 2.5 cm, with variability in colour and areas of regression, almost covering Right side of nose. The patch appeared light brown with areas of dark brown and black. Differential diagnoses considered were Lentigo maligna melanoma (LMM), Solar Lentigo (SL), and flat seborrheic keratosis. Dermoscopy (Polarised illuco IDS-1100 dermoscope) revealed diffuse brown pigmentation with a faint pigmented network, along with dark brown to black globules and blotches. Due to the asymmetry of pigmentation, a punch biopsy was performed from the area of darkest pigmentation to rule out LMM. In Histology, the epidermis exhibited hyperkeratosis, follicular plugging, acanthosis, and downward elongation of the rete ridges. There was hyperpigmentation of the basal layer, an increased number of melanocytes, and the presence of melanophages in the papillary dermis. The biopsy report was consistent with Solar Lentigo (SL), and we concluded it as unstable solar lentigo (USL). This case is presented due to its clinical and dermoscopic resemblance to LMM and to increase awareness of USL and the importance of periodic surveillance.

Relapsing Irritated Seborrheic Keratosis of External Auditory Canal and its Management.

Seborrheic keratosis lesions are tumors that rarely occur in the external auditory canal. There are several histological variants, and one of them is the irritated seborrheic keratosis. This kind has been scarcely reported in the literature. We report a 62 years old man with this lesion that relapses after monopolar electrocautery, and finally is removed by skin flap dissection.

Deep convolutional neural network with fusion strategy for skin cancer recognition: model development and validation

We aimed to develop an accurate and efficient skin cancer classification system using deep-learning technology with a relatively small dataset of clinical images. We proposed a novel skin cancer classification method, SkinFLNet, which utilizes model fusion and lifelong learning technologies. The SkinFLNet's deep convolutional neural networks were trained using a dataset of 1215 clinical images of skin tumors diagnosed at Taichung and Taipei Veterans General Hospital between 2015 and 2020. The dataset comprised five categories: benign nevus, seborrheic keratosis, basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. The SkinFLNet's performance was evaluated using 463 clinical images between January and December 2021. SkinFLNet achieved an overall classification accuracy of 85%, precision of 85%, recall of 82%, F-score of 82%, sensitivity of 82%, and specificity of 93%, outperforming other deep convolutional neural network models. We also compared SkinFLNet's performance with that of three board-certified dermatologists, and the average overall performance of SkinFLNet was comparable to, or even better than, the dermatologists. Our study presents an efficient skin cancer classification system utilizing model fusion and lifelong learning technologies that can be trained on a relatively small dataset. This system can potentially improve skin cancer screening accuracy in clinical practice.

Comparison of the clinical characteristics of benign and malignant eyelid lesions: an analysis of 1423 eyelid lesions, compared between ophthalmology department and plastics department.

Oculoplastic surgeons excise and reconstruct eyelid tumors, although plastic surgeons have traditionally managed these cases. Current demand of this surgery is growing, and planning referral services is a health management necessity. This pilot study retrospectively reviewed same population eyelid specimens excised by both disciplines comparing data. Clinical and epidemiologic features of 1423 eyelid lesions biopsied between 2015- 2020 in Emek Medical Center (EMC), Israel were reviewed. Among 1423 specimens, 1210 (85.0%) were benign and 213 (15.0%) were malignant/pre-malignant. Mean age at diagnosis was significantly higher in malignant tumors than in benign tumors (76 and 59years respectively, p value < 0.001). The most common benign eyelid lesions were soft fibroma (20.1%), seborrheic keratosis (11.0%) and melanocytic nevus (10.3%). The most common malignant/pre-malignant eyelid tumors were basal cell carcinoma (BCC) (9.2%), actinic keratosis (2.6%) and Bowen's disease (1.9%). Ophthalmology removed 37 malignant/pre-malignant lesions (5.4%) out of 683 compared to plastics removing 142 malignant/pre-malignant lesions out of 740 (19.2%) specimens. Eyelid malignancy in the plastics department was significantly higher than in the ophthalmology department (p value < 0.001). 270 (70.0%) lesions caused by UV exposure were removed by plastics and 116 (30.0%) were removed by ophthalmology (p value < 0.001). Eyelid lesions in patients aged 76 or older are more likely to be malignant. Ophthalmology eyelid specimens in younger patients are more commonly benign and related to inflammation. Specimens from the plastics department are more commonly malignant, related to UV-exposure, and are from older patients. This difference may be due to a misconception that plastic surgeons have more eyelid cancer reconstruction experience than oculoplastic surgeons, or less awareness of the oculoplastic expertise available today.

Dermoscopy of atypical pigmented lesions of the face: Variation according to facial areas.

Atypical pigmented facial lesions (aPFLs)-including lentigo maligna (LM) and lentigo maligna melanoma (LMM), solar lentigo (SL), pigmented actinic keratosis (PAK), atypical nevi (AN), seborrheic keratosis (SK) and lichen planus-like keratosis (LPLK)-can exhibit clinical and dermoscopic overlapping features. We aimed to investigate if and how 14 dermoscopic features suggestive for the aforementioned aPFLs vary according to six facial sites among 1197 aPFLs cases (excised to rule out malignancy) along with lesion and patients' metadata. According to distribution and association analysis, aPFLs on the forehead of a male patient aged > 69 years displaying the obliterated follicular openings pattern, appear to be more at risk of malignancy. Of converse, aPFLs of the orbital/cheek/nose area with evident and regular follicular openings with diameter < 10 mm in a female aged below 68 are probably benign. The obliterated follicular openings, keratin plugs, evident and regular follicular openings and target-like pattern features differed significantly among six facial areas in all aPFLs cases. Lesion of the nose may show both features suggestive of malignancy and benignity (e.g. many SL and PAK may display target-like pattern and some LM/LMM cases display keratin plugs and evident and follicular openings), making these features less specific.

Concordance of in vivo reflectance confocal microscopy and horizontal-sectioning histology in skin tumours.

In vivo reflectance confocal microscopy (RCM) enables the study of architectural and cytological aspects in horizontal sections, which closely correlate with histologic features. However, traditional histopathological vertical sections cannot totally reproduce the image of the in vivo RCM horizontal section. To evaluate the concordance between in vivo RCM and histopathologic transverse sections for melanocytic lesions, basal cell carcinoma and seborrheic keratoses. Prospectively collected benign melanocytic and non-melanocytic tumours diagnosed by dermoscopy were evaluated for common RCM features and compared to histopathology in horizontal sections with haematoxylin and eosin staining. A total of 44 skin tumours including 19 melanocytic lesions (nine compound, five junctional and five intradermal nevi), 12 basal cell carcinomas and 13 seborrheic keratoses were collected in the Department of Dermatology of Hospital Clinic of Barcelona. The RCM features that had statistically significant agreement with the histopathological horizontal sections were the preserved and visible honeycomb pattern, well defined DEJ, small bright particles, dermal nests, tumour islands and dark silhouettes, clefting, collagen bundles, thickened collagen bundles and cytologic atypia. Histopathology evaluation of horizontal sections of skin tumours can be correlated with main RCM findings. The results of this study have improved the understanding and interpretation of RCM features in relation to skin tumours, thus reinforcing the utility of RCM as a diagnostic tool.

Transcriptional repressor GATA binding 1 (TRPS1) immunoexpression in normal skin tissues and various cutaneous tumors.

Transcriptional repressor GATA binding 1 (TRPS1) is a transcription factor recently shown to play a role in the development of breast and liver cancer. Here, we evaluate TRPS1 immunoexpression in normal skin tissues and various cutaneous tumors. TRPS1 immunohistochemistry was performed in 109 cases of primary cutaneous tumors and 19 cases of metastatic carcinomas. TRPS1 expression was also evaluated in the normal skin tissues. The normal epidermis was TRPS1-. In contrast, the eccrine apparatus, epithelial compartment of the hair follicles, hair papilla, sebaceous glands, and anogenital mammary-like glands were TRPS1+. In primary cutaneous tumors, TRPS1 positivity varied in poroma (2/3), nodular hidradenoma (4/5), spiradenoma (4/4), cutaneous mixed tumor (5/5), trichilemmal cyst (7/8), proliferating trichilemmal tumor (1/3), pilomatricoma (9/9), sebaceoma (2/5), extramammary Paget disease (13/13), sebaceous carcinoma (2/2), actinic keratosis (3/10), Bowen disease (7/12), and squamous cell carcinoma (1/5) cases. All cases of seborrheic keratosis, basal cell carcinoma, Merkel cell carcinoma, and malignant melanoma were TRPS1-. All metastatic breast carcinoma cases (8/8) were highly positive for TRPS1, while all but one of the other metastatic tumor cases were TRPS1-. TRPS1 immunoexpression was observed in several skin appendages and cutaneous tumors.

Back to Basics

ABSTRACT Lentigo maligna (LM) is a melanocytic neoplasm that occurs on chronically sun-exposed skin commonly affecting middle-aged and elderly patients, which can progress to LM melanoma if left untreated or misdiagnosed. LM can be confused with other dermatologic conditions such as pigmented actinic keratosis, solar lentigo, and seborrheic keratosis. Therefore, clinicians should know the various clinical features that can distinguish LM from other differential diagnoses. Although multiple treatment modalities exist for LM, surgical excision remains the gold standard for the treatment of LM and results in an excellent prognosis for treated patients. This article discusses the pathogenesis, diagnosis, and treatment of LM so that dermatology nurses are better prepared to care for patients with LM.