The Journal of dermatology
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The patient is a 13-year-old female who had had a patchy lesion on her back since birth which increased in size proportional to her age. When she visited our hospital at the age of 13, the lesion was a 30 x 43 mm, slightly depressed, well defined, irregularly shaped, atrophic plaque. Differential clinical diagnoses at that time included macular atrophy, congenital melanocytic nevus, and mastocytosis. ⋯ The tumor cells had oval nuclei with relatively abundant cytoplasm and were similar to nevus cells. They were negative for markers such as S-100 protein, neuron specific enolase, epithelial membrane antigen, HMB-45, Leu 7, Desmin, and alpha smooth muscle actin. However, the histopathological findings suggest that the lesion is a melanocytic or neurogenic tumor, possibly a congenital melanocytic nevus or a cellular neurothekoma, though a definite diagnosis could not be made.
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Two cases of intravascular papillary endothelial hyperplasia (IPEH) are described. Each patient was a 49-year-old Japanese woman with a tender eruption on the sole. ⋯ Newly formed vascular channels were seen at the periphery of the thrombus. These findings favored the hypothesis that IPEH usually results from peculiar organization of a thrombus.
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Two cases of trichilemmal carcinoma (TLC) developing in burn scars are reported. In Case 1, a 73-year-old man developed a TLC on his left lower leg five years after a burn. In Case 2, a 43-year-old man developed a cauliflower-like mass on his head 42 years after a burn. ⋯ Tumor nests were mostly composed of large atypical cells with clear cytoplasms containing PAS-positive, diastase sensitive materials. Some of the nests showed trichilemmal-type keratinization. These cases were treated only with surgical excision, and there has been no evidence since of local recurrence or metastasis.
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Case Reports
A case of acral melanocytic hyperplasia: a unique pigmented lesion mimicking acral lentiginous melanoma in situ.
A mottled black pigmented patch on the sole of the foot is reported. Clinically, the lesion closely mimicked acral lentiginous melanoma in situ. However, the histologic findings revealed melanocytic hyperplasia with minimal cytologic atypia confined to the epidermis. Irregular pigmented patches in the acral region comprise a heterogenous group of lesions that range from benign melanocytic hyperplasia to acral lentiginous melanoma.
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The etiology of pilonidal sinus remains controversial. Some think it is congenital, and others think it is acquired. ⋯ Histological examination showed that no epidermis or hair follicle was present in the inner wall of the sinus. This case shows that acquired pilonidal sinus is due to invasion of external hairs and that this condition needs to be distinguished from congenital pilonidal sinus.