Abstract:
BACKGROUND:Infection with parvovirus B19 (B19) has been associated with connective tissue disease (CTD) stigmata, namely, a systemic lupus erythematosus (SLE)-like illness, seronegative polyarthritis resembling rheumatoid arthritis, and vasculitis. The dermatopathology and pathogenetic basis of such B19-associated CTD-like syndromes have not been elucidated. OBJECTIVE:We attempted to document persistence of the B19 genome in skin lesions of 7 patients with CTD-like symptomatology following B19 infection and to correlate systemic manifestations to dermatopathological findings. METHOD:In 7 prospectively encountered patients in whom history, clinical signs and/or serology supported a diagnosis of CTD in the setting of B19 infection, dermatopathological and clinical features were correlated. Parvovirus B19 viral genome was sought in skin tissue using the polymerase chain reaction (PCR). RESULTS:Two patients had clinical features diagnostic of myopathic dermatomyositis (DM), 1 of whom is still symptomatic 1.5 years after the onset of her illness, and the other has had typical clinical features of DM for a duration of 3.5 years. A 3rd patient with SLE remains symptomatic 4 years after the onset of her illness. A 4th patient has persistent seronegative symmetrical polyarthritis of 6 years' duration and cutaneous lesions of granuloma annulare (GA). The 5th patient has a 1.5-year history of debilitating polyarthritis and cutaneous lesions with overlap features of DM and subacute cutaneous LE (SCLE). The 6th patient has had a persistent folliculocentric necrotizing vasculitis for 3 years. The 7th patient has a 1-year history of microscopic polyarteritis nodosa (PAN) with cutaneous vasculitis and persistent active renal disease. In 4 patients, exposure to children with fifth disease immediately preceded the onset of their CTD. Parvovirus B19 infection was documented serologically in 6 patients with antibodies of IgG subclass in 6 and of IgM subclass in 1. Four of 6 patients questioned had a history of atopy. Skin biopsies from patients with clinical features of SLE or DM demonstrated an interface dermatitis with dermal mucinosis. A necrotizing vasculitis with epithelial pustulation was seen in 2 patients. Interstitial GA-like infiltrates were seen in 5 cases. Immunofluorescent (IF) testing revealed a positive lupus band test (LBT) and epidermal nuclear and vascular staining for IgG and C5b-9 in the SLE patient. One DM patient had a negative LBT in concert with C5b-9 deposition along the dermoepidermal junction (DEJ) and within blood vessels while the other showed endomysial vascular Cs5b-9 deposition. In all patients, skin biopsy material contained B19 genome, which was absent in the serum of 4 patients analyzed. Symptomatic relief followed immunosuppressive and immunomodulatory therapy with agents including prednisone, cyclophosphamide, hydroxychloroquine, non-steroidal anti-inflammatory drugs and etanercept, but no patient has had complete symptom resolution. CONCLUSIONS:Persistent B19 infection may be of pathogenetic importance in certain prototypic CTD syndromes, to which underlying immune dysregulation associated with a blunted IgM response to viral antigen may predispose. Anti-viral therapy might be worthy of consideration since traditional immunosuppressive therapy was unsuccessful in our cases.
journal_name
J Cutan Patholjournal_title
Journal of cutaneous pathologyauthors
Crowson AN,Magro CM,Dawood MRdoi
10.1034/j.1600-0560.2000.027010505.xkeywords:
subject
Has Abstractpub_date
2000-11-01 00:00:00pages
505-15issue
10eissn
0303-6987issn
1600-0560journal_volume
27pub_type
杂志文章abstract::An 11-year old Caucasian female with a remote history of urticaria pigmentosa presented with a neck mass. A biopsy demonstrated a large intradermal nodule composed of unusually large epithelioid mast cells, including a prominent subset with bi-lobed and multi-lobed nuclei. By immunohistochemistry, the cells expressed ...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.2009.01257.x
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Scleroderma/morphea is characterized by expansion of the dermis with thickened collagen bundles and loss of CD34(+) dermal dendrocytes. Variable elastic fiber changes have been described, but to our knowledge, no systematic study of the elastic fiber pattern correlated with CD34 expression has been reported....
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.2009.01201.x
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor arising predominantly on sun-exposed skin of older and usually immunosuppressed individuals. METHODS:Using data from NCI's SEER (Surveillance, Epidemiology, and End Results) Program from 1973 to 2006, we analyzed the demographics and ...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.2009.01370.x
更新日期:2010-01-01 00:00:00
abstract::The diagnosis of a CD30+ cutaneous infiltrate is often difficult and requires clinicopathologic correlation. To further evaluate this challenge, initial clinical and histopathologic diagnoses were correlated with final clinicopathologic diagnosis in 44 cases with CD30 immunopositivity. Dermatopathologic evaluation con...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/cup.12510
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Telomerase plays a role in the immortalization of cells and carcinogenesis. Previous studies have yielded conflicting results on whether human telomerase RNA (hTER) expression differs in nevi, atypical nevi and melanomas using polymerase chain reaction-based telomeric repeat amplification protocol or in situ...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.0303-6987.2005.00403.x
更新日期:2005-11-01 00:00:00
abstract::A giant cell fibroblastoma (GCF) presented in the subcutis of the breast in a 13-month-old girl which recurred 6 years later as a dermal and subcutaneous neoplasm whose patterns were in part GCF and spindle cells with a storiform configuration resembling dermatofibrosarcoma protuberans (DFSP). The issue remains unsett...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.1993.tb00670.x
更新日期:1993-10-01 00:00:00
abstract::Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue tumor that arises primarily on the trunk and extremities but seldom on the scalp. Several variants of DFSP have been described, including myxoid DFSP. Although typical DFSP may have focally myxoid areas, myxoid DFSP, in which most of the stroma is myxoid, is...
journal_title:Journal of cutaneous pathology
pub_type:
doi:10.1111/cup.13130
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Angiosarcomas arise in the scalp and face in the elderly, in association with chronic lymphedema (Stewart-Treves syndrome), and in irradiated areas. Rarely in these settings, angiosarcomas exhibit pure spindle cell phenotype. METHODS:Herein, the clinicopathologic features of a 72-year-old-woman with spindle...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1034/j.1600-0560.2002.290206.x
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:The Fli-1 transcription factor functions in cellular proliferation and tumorigenesis. Its role in various neoplasms and its presence in lymphocytes suggest a link between Fli-1 dysregulation and the pathogenesis of mycosis fungoides (MF). In this study, we further elucidate this possible link. METHODS:Secti...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.2006.00535.x
更新日期:2006-09-01 00:00:00
abstract::CD44 is a widely distributed cell surface protein thought to be involved in multiple steps of normal immune cell function, including T-cell activation, and in cellular adhesion where it mediates cell attachment to hyaluronate. In normal skin, CD44 is found by immunohistochemical means to be primarily in eccrine coil c...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.1994.tb00265.x
更新日期:1994-06-01 00:00:00
abstract::This report documents the case of a 64-year-old African-American female with new end-stage renal disease (ESRD), diagnosed with systemic lupus erythematosus (SLE) on renal biopsy and serologies including a positive ANA (>1:2560), positive anti-Sm antibodies, low titer anti-RNP antibodies, high titer anti-Ro antibodies...
journal_title:Journal of cutaneous pathology
pub_type:
doi:10.1111/cup.13493
更新日期:2019-09-01 00:00:00
abstract::Endometriosis is a condition where endometrial glands and stroma are ectopically located in sites other than the uterine cavity. Cutaneous endometriosis is very rare, representing approximately 1.1% of cases of extrapelvic endometriosis. We report a case of a 44-year-old female with no prior surgical history who prese...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.2011.01681.x
更新日期:2011-06-01 00:00:00
abstract::Perifollicular fibroma is a cutaneous hamartomatous proliferation of the pilar connective tissue sheath. We describe a patient with multiple perifollicular fibromas and analyze the literature on this topic. Histologically, perifollicular fibroma is characterized by a concentric arrangement of collagen fibers surroundi...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章,评审
doi:10.1111/j.1600-0560.1994.tb00291.x
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the effectiveness of CD117 immunostaining for diagnosing cutaneous adnexal tumors, which has not been previously established. METHODS:CD117 immunostaining was performed on representative sections of 87 clinicopathologically confirmed cutaneous apocrine/eccrine tumors, 1...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/cup.12492
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:De novo intraepidermal epithelioid melanocytic dysplasia (DNIEMD) is a newly characterized lesion that is associated with a personal and/or family history of malignant melanoma (MM) and/or dysplastic nevi (DN). However, the biological significance is still uncertain and the persons predisposed to this lesion...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.2009.01429.x
更新日期:2010-08-01 00:00:00
abstract::Penicillamine-induced cutaneous elastosis perforans serpiginosa associated with a large air-cyst in the right lung is described in a 29-year-old female patient with Wilson disease. Identical light and electron-microscopic changes were present in both dermal and pulmonary elastic tissue, suggesting a disseminated drug-...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.1979.tb01131.x
更新日期:1979-08-01 00:00:00
abstract::Twenty-nine cases of histiocytic neoplasms, some resembling juvenile xanthogranuloma (JXG) and others resembling reticulohistiocytoma (RH), were evaluated. Immunohistochemical stains were performed. In this series, seven cases were identified that expressed S-100 protein positive cells. The S-100 positive cells were p...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章,评审
doi:10.1111/j.1600-0560.1998.tb01704.x
更新日期:1998-03-01 00:00:00
abstract::Trichilemmoma is considered a benign neoplasm derived from the outer root sheath of the hair follicle. Although the histogenesis of the lesion is unknown, a relationship between human papillomavirus (HPV) infection and development of these tumors has been suggested on morphologic observations. In order to determine wh...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.1991.tb00152.x
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:Morphea (localized scleroderma) and eosinophilic fasciitis (EF) are rare fibrosing disorders which may present a diagnostic challenge. While histopathologic features are often distinct, in some cases there may be overlap. T-cells contribute to etiopathogenesis of both autoimmune conditions. We sought to dete...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/cup.12947
更新日期:2017-06-01 00:00:00
abstract::Pleomorphic fibromas represent dome-shaped or polypoid cutaneous lesions characterized by a paucicellular and densely fibrotic background punctuated by scattered atypical to pleomorphic spindle and multinucleated giant cells. Some of these tumors will have incorporated adipose tissue, although these adipocytic areas l...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/cup.12095
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Some examples of Bowen disease lack the characteristic broad parakeratosis making their histopathologic diagnosis particularly difficult in small and incomplete biopsies. MATERIALS AND METHODS:The archives of our dermatopathology laboratory were searched for cases of Bowen disease with >75% orthokeratosis (...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/cup.12610
更新日期:2016-01-01 00:00:00
abstract::Sarcoidosis is a granulomatous condition with diverse clinical presentations, including neurological findings. It was previously hypothesized that perineural sarcoidal granulomas in the skin may be an explanation of small-fiber neuropathy. Herein, we present a case of a 55 year old female with anesthetic cutaneous les...
journal_title:Journal of cutaneous pathology
pub_type:
doi:10.1111/cup.13660
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Myxoid liposarcoma typically presents as a deep-seated mass in the lower extremity of adults. Presentation as a primary subcutaneous tumor is rare. Here we discuss clinicopathologic characteristics of three such cases and their differential diagnosis to alert dermatopathologists to this unusual clinical pres...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/cup.12428
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is associated with an increased risk of a second malignancy. METHODS:We conducted a retrospective clinicopathologic review of 12 patients with CLL/SLL who developed a second lymphoma in the skin. Demographic data, clinical information, and hi...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/cup.13956
更新日期:2021-01-07 00:00:00
abstract::A survey of conditions with mucinous deposits is given. The most important factors for their diagnosis are to consider these disorders and to stain the slides for proteoglycans or glycosaminoglycans; the most common routine techniques are the Giemsa and the Alcian-blue stain. More sophisticated methods allow different...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.1985.tb01637.x
更新日期:1985-06-01 00:00:00
abstract::Immunotherapies targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and the programmed cell death 1 (PD-1) receptor and its ligand (PD-L1) have showed significant therapeutic benefit in patients with clinically advanced solid malignancies, including melanoma. However, immune-related adverse events (irAE) ar...
journal_title:Journal of cutaneous pathology
pub_type:
doi:10.1111/cup.13150
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Hypertrophic lichen planus (LP) is a variant of LP favoring the lower extremities and showing prominent epidermal hyperplasia and hyperorthokeratosis. Contrary to dogma that eosinophils are rare in LP and variants, we noticed that some cases of hypertrophic LP have eosinophils in the absence of drug history....
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/cup.12275
更新日期:2014-04-01 00:00:00
abstract::Facial inflammatory dermatoses can be difficult to diagnose in their early stages; skin biopsy may help but often shows indeterminate features. The aims of our study were to identify patients presenting with a facial dermatosis requiring skin biopsy, in whom the initial histological features were classified as "non-sp...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/j.1600-0560.1995.tb01400.x
更新日期:1995-04-01 00:00:00
abstract::Melanoma is known to show considerable variation in its histopathological presentation. In exceptional cases, heterologous or divergent differentiation (metaplastic melanoma) can be observed. We report a case of a 69-year-old man who was diagnosed with nodular melanoma on the right upper leg. One year later, the patie...
journal_title:Journal of cutaneous pathology
pub_type:
doi:10.1111/cup.13857
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Chronic graft-vs.-host disease (GVHD) is a severe and potentially fatal complication in patients after undergoing allogeneic stem cell transplant. This disease may be hard to diagnose as it has numerous cutaneous presentations. METHODS:We report four cases of patients seen at Stanford Hospital between Janua...
journal_title:Journal of cutaneous pathology
pub_type: 杂志文章
doi:10.1111/cup.12640
更新日期:2016-03-01 00:00:00