#dermpathJC December 2018 summary

Thursday, December 27, 9pm EST

Article discussed: Selected Pseudoneoplastic Lesions of the Skin

Author: Mark R. Wick and James W. Patterson

Open access at: http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165-134.3.369

Summary prepared by Jisun Cha, MD (@sunpungi)

 

Journal Club Summary:

Hair follicle “bulges” (der Wulst) are commonly seen in dermpath sections. How they differentiate from BCC – usually vertically oriented, surrounded by normal dermis, prominent basement membrane, no mitoses, no atypia and lack of myxoid stroma. Normal structure of hair follicles in the central facial skin.

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PEH (Pseudoepitheliomatous hyperplasia) can be associated with many different types of lesions. Here is a nice summary table from @SGottesmanMD.

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Most dermpathJC participants agree that verrucous carcinoma can be quite impossible to distinguish from pseudoepitheliomatous hyperplasia in certain scenarios. This is where additional clinical information may be helpful.

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Pseuodsarcomatous fibroepithelial polyp – fatty core which shows pleomorphic lipoblast-like cells which have similarity to pleomorphic lipomas and some deep soft tissue sarcomas (liposracoma). These changes are thought to be of a degenerative nature. They are very rare as most dermpathJC participants have never seen such changes in fibroepithelial polyps. @JMGardnerMD is wondering if some of these are in the pleomorphic fibroma/lipoma spectrum, and would be cool to do RB1 on a specimen like this. Additional reading about loss of retinblastoma in pleomorphic fibroma: https://www.ncbi.nlm.nih.gov/m/pubmed/28543636/

3Acroangiodermatitis of Mali aka dermatitis hemostatica aka Bluefarb-Stewart syndrome aka pseudo-Kaposi sarcoma. Here’s another useful table from @SGottesmanMD.

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Reactive angioendotheliomatosis (term used in several different ways and is still confusing to most participants)

  • Reactive vascular proliferation
  • Reactive histiocytes proliferation filling dilated vessels

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And last but not least, basaloid, follicular and sebaceous induction over a dermatofibroma. Photos by , and

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Hope you have a happy New Year and we will see you January 24th, 2019 at 9pm EST for another exciting dermpath journal club.

 

Kind regards,

Silvija Gottesman, MD

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