Epidemiological, Clinical, Trichoscopic, and Histopathological Features of Lupus Erythematous Mimicking Alopecia Areata: A Multicenter Retrospective Study

<b><i>Introduction:</i></b> All types of lupus erythematosus (LE) may cause hair loss. Nonscarring alopecia was correlated with systemic LE, based on its high specificity. Discoid LE can also appear as nonscarring patches in early stages. Patchy alopecia LE-specific may also mimic alopecia areata (AA) – which can co-occur with LE. The distinction is fundamental to early diagnosis and effective treatment. This study aims to analyze clinical, epidemiological, trichoscopic, and histopathological features of patients with patchy LE-specific alopecia, nonscarring type, mimicking AA. <b><i>Methods:</i></b> This is a multicentric retrospective study. We reviewed the medical records of patients with a confirmed diagnosis of LE mimicking AA. <b><i>Results:</i></b> Ten patients were included (90% female) with a mean age of 45.9 years. Clinically, 60% showed erythema and 70% presented incomplete hair loss. The most common trichoscopic findings were interfollicular arborizing vessels (90%) and scattered brown discoloration (80%). On histopathology, perivascular inflammation (85.7%), peribulbar lymphocytes (85.7%), and dermal pigment incontinence (71.4%) were present in most cases. <b><i>Discussion/Conclusion:</i></b> Trichoscopy was found as an essential first step for the patchy alopecia diagnosis, enabling to differentiate LE from AA. Putting it mildly, trichoscopy raises the suspicion that leads to a biopsy, increasing the diagnostic accuracy with better outcome for patients.

A Unique Case of the Transformation of a Hepatic Leiomyoma into Leiomyosarcoma with Pancreatic Metastases: Review of the Literature with Case Presentation

Primary hepatic leiomyoma (PHL) is a rare entity, with very few cases reported in the literature. Even more rarely, until now practically undescribed, is the transformation of a hepatic leiomyoma into leiomyosarcoma with pancreatic metastases. Here, we report a single case of the progression of PHL in primary hepatic leiomyosarcoma, with clinical–surgical and histopathological features, and we conducted a review of the literature of related cases that can be found.

A New Vision about Folliculitis Decalvans and Lichen Planopilaris: Two Distinct Entities or a Continuous Phenotypic Spectrum?

Folliculitis decalvans and lichen planopilaris have been considered two distinct cicatricial alopecias. However, biphasic presentation of folliculitis decalvans - lichen planopilaris in the same patient has been recently described, therefore raising the doubt if they are two distinct entities or a continuous phenotypic spectrum.We describe the case of a man who presented clinical, trichoscopic, and histopathological features of both entities. Moreover, we discuss current theories about the pathogenesis of the two diseases and their coexistence in the same patient. The recognition of similar cases allows to optimize the approach and treatment.

Beware of the Impostors—Scalp Pathology Primer for the Hair Transplant Surgeon

Histopathological features are important for the practicing hair transplant surgeon to ensure proper case selection, diagnosis, choice of proper treatment, and successful outcome. While the primary focus of the hair transplant surgeon is androgenetic alopecia (AGA), it is important to be aware of other conditions that can mimic AGA, whose treatment may be different. This article outlines some of these conditions such as scarring alopecias, alopecia areata, etc., and how to distinguish them. Proper identification will ensure proper treatment and avoid potential missteps in management.

Clinico-pathological correlation of linear dermatoses along the lines of Blaschko: An observational study

Several epidemiological studies have described linear dermatoses; however, only few studies have correlated linear dermatoses along Blaschko’s lines with the histopathological findings. The aims of this study were to investigate the clinical patterns of various linear dermatological lesions along Blaschko’s lines and investigate the correlations between these dermatological lesions and their histopathological features. Patients who attended our dermatology out-patient department with linear dermatoses along the Blaschko’s lines were included in the study. Detailed history was obtained, clinical examination was performed, and a final provisional clinical diagnosis was noted. Subsequently, biopsy of the lesions was performed for histopathological examination. Of 62 patients who presented with linear lesions along the Blaschko’s lines, 45 patients underwent biopsy and histopathological examination. Of 45 patients who underwent biopsy, clinico-pathological correlation was observed in 100% of those diagnosed with lichen striatus and linear morphea, 89% of those diagnosed with hypomelanosis of Ito, 80% of those diagnosed with linear epidermal nevus, 75% of those diagnosed with lichen planus, and 67% of those diagnosed with nevus depigmentosus. The importance of correlation of linear lesions with their histopathological features in dermatology cannot be over emphasized. However, 100% correlation may be wishful thinking, and a correlation can help choose the appropriate line of management. Our results highlight this discrepancy and add to the knowledge on linear dermatosis.

Innocuous Lesions and Not so Innocuous Lesions of the Skin and Soft Tissue

Background: Cystic lesions of the skin and soft tissue are often neglected and thought to be innocuous or harmless. These lesions need to be excised to exclude malignancy. The lesions may present in unusual sites and may also be of infective origin. Thus, there is an urgent need to determine the prevalence and identify the histopathological features of the cystic lesions as the innocuous appearing lesions may actually not be so innocuous. In addition, it is the histopathological features that determine the treatment modality. Aim: To determine the features and prevalence of the types of cysts in skin and soft tissue. Materials and Methods: A retrospective study of the cystic lesions of the skin and soft tissue was conducted. The records from the Department of Pathology, Saveetha Medical College were retrieved and reviewed for patients with cystic lesions of the skin and soft tissue over a one year period extending between January 2019 and December 2019. The records were examined for the following data : age, sex, type of lesion, clinical and histopathological diagnosis. Results: In all 109 cases with skin and soft tissue swellings were analyzed. Among these 53 were males and 56 were more females reported (51 %) of cystic swellings as compared to males (48%). Cystic lesions were most commonly encountered in the age group of 18 to 40 years, which suggests that there may be a role for trauma or occupation related occurrence. A variety of cysts were encountered such as epidermoid cysts (70%), Trichilemmal cyst (7%), and Ganglion (7%).Phaeohyphomycotic cyst, mucous retention cyst, hemangioma and pilomatrixoma. Epidermal cysts were more frequently encountered in males (54%) than females (46%).Most lesions occurred in the back. Conclusion: Epidermal cysts may frequently be associated certain syndromes, hence it is important to evaluate these cysts. In addition phaeohyphomycotic cysts may be mistaken for Ganglion, so histopathological examination is necessary to initiate appropriate therapy.

Sequential IVIM-Parametric as a Potential Image Biomarker in Evaluating the Radiosensitivity of Human Nasopharyngeal Carcinoma Xenografts

BACKGROUND AND PURPOSEIntravoxel incoherent motion (IVIM) is a considerable functional MR sequence in evaluated the tumor’s response to chemo-radiotherapy. Our aim was to investigate the sequential IVIM parametric in assessing the dynamic changes of histopathological features on nasopharyngeal carcinoma (NPC) xenografts after receiving the fractional radiations.EXPERIMENTAL APPROACH: Sixty BALB/c-nu nude mice were transplanted with NPC cell lines of CNE-1 and CNE-2 to raise xenografts which further received the fractional radiations. On 3.0T MR system, IVIM (14 b-factors: 0~1000 s/mm2) was performed on xegnorafts after radiations. IVIM-parametric of D, f and D* accompanied with the cellularity and necrosis proportion of NPC xenografts were calculated and analyzed respectively.KEY RESULTSNPC xenografts exhibited a larger D and necrosis proportion coupled with a smaller D*, f and cellularity after fractional radiations, and CNE-2 xenografts presented greater changes than CNE-1 xenografts (all P<0.01). Parametric D and f correlated negatively (r=-0.824, P<0.001) while D* correlated positively with f (r=0.758, P<0.001) and D (r=0.625, P=0.042). Moreover, D correlated negatively with cellularity (rs=-0.861, P<0.001) and positively with necrosis proportion (rs=0.952, P<0.001), f behaved a positive correlation with cellularity (rs=0.627, P<0.001) and negative with necrosis proportion (rs=-0.649, P<0.001). CONCLUSIONS AND IMPLICATIONS: Sequential parametric derived from IVIM are valuable in characterizing the dynamic changes in histopathological features of NPC xenografts and can be utilized as a potential image biomarker for non-invasive assessment of tumor’s radiosensitivity.

Blastomicose Sul Americana e suas manifestações na cavidade oral

Considerations about concept, nomenclature, clinical and histopathological features of the lesion. It is stressed how important is the precocious diagnosis onde the main way for parasite entrance is oral cavity.