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Tang H, Seykora JT, Ko CJ. Squamous carcinogenesis: potential truncal mutations. Hum Pathol 2023; 140:32-38. [PMID: 37001739 DOI: 10.1016/j.humpath.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
Squamous carcinogenesis is incompletely understood, but more recent genetic studies support that the order of acquired mutations is important. This paper will review more recent genetic studies with an emphasis on the potential truncal mutations, mutations critical to the trunk of the cancer evolutionary tree, in actinic keratosis, squamous cell carcinoma in situ, cutaneous squamous cell carcinoma, keratoacanthoma, and keratoacanthoma-like squamous proliferation.
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Affiliation(s)
- Haiming Tang
- Department of Pathology, School of Medicine, Yale University, New Haven, CT, 06510, USA.
| | - John T Seykora
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christine J Ko
- Department of Pathology, School of Medicine, Yale University, New Haven, CT, 06510, USA; Department of Dermatology, School of Medicine, Yale University, New Haven, CT, 06510, USA
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2
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Litaiem N, Khammouma F, Mrad M, Bacha T, Belhadj Kacem L, Zeglaoui F. Multiple keratoacanthomas of Ferguson-Smith type. Clin Case Rep 2022; 10:e06429. [PMID: 36245454 PMCID: PMC9552544 DOI: 10.1002/ccr3.6429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/29/2022] [Accepted: 09/21/2022] [Indexed: 11/09/2022] Open
Abstract
We report a case of a 41-year-old male patient with no family history, presented with extensive multiple keratoacanthomas with disfiguring scars. The diagnosis of a sporadic form of Ferguson-Smith syndrome was made. Treatment with acitretin showed a marked response. Recognizing this syndrome is crucial. Early treatment helps avoid scar formation.
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Affiliation(s)
- Noureddine Litaiem
- Department of DermatologyCharles Nicolle HospitalTunisTunisia,Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Ferdaous Khammouma
- Department of DermatologyCharles Nicolle HospitalTunisTunisia,Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Malek Mrad
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
| | - Takwa Bacha
- Department of DermatologyCharles Nicolle HospitalTunisTunisia,Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Linda Belhadj Kacem
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia,Department of PathologyCharles Nicolle HospitalTunisTunisia
| | - Faten Zeglaoui
- Department of DermatologyCharles Nicolle HospitalTunisTunisia,Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
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Wang X, Wang Y, Wang H, Zheng L, Guo Z, Fan X, Gao M. The first report of diagnosing of keratoacanthoma in Chinese Han patients using dermoscopy and reflectance confocal microscopy. Skin Res Technol 2020; 27:422-427. [PMID: 33098126 DOI: 10.1111/srt.12975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/05/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Keratoacanthoma (KA) is a special kind of tumor, which is regarded as a variant of squamous cell carcinoma (SCC) in some academic disciplines. But differentiating KA from SCC remains a diagnostic challenge. The noninvasive techniques dermoscopy and reflectance confocal microscopy (RCM) can provide new insights for diagnosis. OBJECTIVE To observe the characteristics of KA under dermoscopy and reflectance confocal microscopy (RCM), in order to gain experience and reference for clinicians to facilitate earlier diagnosis. METHODS We collected two cases of KA, which were confirmed by clinical and histopathological examination. The two cases were examined by dermoscopy and RCM, respectively. Then, we collected the microscopic characteristics of KA lesions. RESULTS The dermoscopy features of KA are concentric circles of central crater, keratin mass, keratin scale, and polymorphic vascular pattern. The RCM features are described as refractile crust, atypical honeycomb pattern, dark center cells, large round nucleated cells, dendritic cells, and linear or round vessels traversing dermal papillae in the dermis. CONCLUSION KA has some specific dermoscopy and RCM features, which can provide a basis for doctors to diagnose and intervene earlier.
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Affiliation(s)
- Xiuli Wang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Yifan Wang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Hui Wang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Liyun Zheng
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Ze Guo
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Xing Fan
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Min Gao
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
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Fraga GR, Chow P. Plasmacytoid dendritic cells in keratoacanthoma and squamous cell carcinoma: A blinded study of CD123 as a diagnostic marker. J Cutan Pathol 2019; 47:17-21. [PMID: 31449667 DOI: 10.1111/cup.13573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Histopathologic distinction between keratoacanthoma (KA) and squamous cell carcinoma (SCC) is challenging. We surmised that a discriminatory immunostain would be clinically meaningful. Previous investigators have found CD123-positive plasmacytoid dendritic cells (PDCs) are more prominent in KA than SCC. We sought to determine if CD123 immunostaining might have value as a diagnostic test for distinguishing KA from SCC. METHODS We used blinded, semi-automated image analysis to compare CD123 expression in 66 KAs and 63 SCCs in a tissue microarray. RESULTS PDCs were present in both KA and SCC. Mean PDC frequency was higher in KA than SCC (14.2 vs 11.2 mean cells/0.0945 square mm) but the difference was not statistically significant (P = 0.1240). There was no significant difference in mean PDC cluster frequency, mean intratumoral PDC frequency, or the percentage of PDCs as proportion of the total mononuclear inflammatory cell infiltrate between KA and SCC. CONCLUSION CD123 immunostaining is not a clinically useful test for distinguishing KA from SCC.
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Affiliation(s)
- Garth R Fraga
- Department of Pathology, University of Kansas School of Medicine, Kansas City, Kansas
| | - Peter Chow
- Department of Internal Medicine, Scripps Mercy Hospital, San Diego, California
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AlBayyat GJ, Venkateswaran N, Arreaza D, Dubovy SR, Galor A, Karp CL. Spontaneous regression of conjunctival keratoacanthoma. BMJ Case Rep 2019; 12:12/7/e228833. [PMID: 31300607 DOI: 10.1136/bcr-2018-228833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
An 83-year-old white man presented with a rapidly growing conjunctival mass in his left eye over the course of 1 month. While awaiting surgical intervention, the tumour underwent partial, spontaneous regression to half its original size. The lesion was ultimately excised with wide margins using a no-touch technique and application of cryotherapy to the corneal and conjunctival margins and scleral bed. Histopathological analysis revealed a conjunctival keratoacanthoma. To our knowledge, this is the first case documenting the partial, spontaneous regression of a conjunctival keratoacanthoma over a 5 week time course from the time of diagnosis to surgical excision.
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Affiliation(s)
- Ghada J AlBayyat
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | | | - Dan Arreaza
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Sander R Dubovy
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.,Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA.,Department of Pathology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.,Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL, USA
| | - Carol L Karp
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
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Fortuna MC, Grimaldi M, Garelli V, Pranteda G, Pranteda G, Di Nunno D, Carlesimo M, Rossi A. Use of topical ephedrine and naphazoline in the treatment of a keratoacanthoma. GIORN ITAL DERMAT V 2017; 153:881-882. [PMID: 28712267 DOI: 10.23736/s0392-0488.17.05553-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Maria C Fortuna
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Miriam Grimaldi
- Unit of Plastic Surgery, Madonna delle Grazie Hospital, Matera, Italy
| | - Valentina Garelli
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy -
| | - Giulia Pranteda
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Guglielmo Pranteda
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Donato Di Nunno
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Marta Carlesimo
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Alfredo Rossi
- Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
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Retraction Note: Clinico-histopathologic and outcome features of cutaneous infundibular keratinizing acanthoma: a case report and literature review. World J Surg Oncol 2016; 14:282. [PMID: 27814733 PMCID: PMC5096320 DOI: 10.1186/s12957-016-1032-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 10/20/2016] [Indexed: 11/10/2022] Open
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Munday WR, Leffell DJ, McNiff JM, Ko CJ. Histopathologic features of multiple cutaneous squamous cell carcinomas of the lower extremity. J Cutan Pathol 2016; 43:759-65. [PMID: 27220356 DOI: 10.1111/cup.12738] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 05/18/2016] [Accepted: 05/22/2016] [Indexed: 11/29/2022]
Abstract
Recent studies suggest cutaneous squamous cell carcinomas (SCCs) of the leg, particularly those occurring multiply in sun exposed skin of nonimmunosuppressed women, are a distinct clinical subtype. There are few reports of the histopathologic features of this subtype. A retrospective chart review of 4 patients with multiple SCCs on the leg was performed and a total of 35 biopsies from the legs examined. Histopathologically, the tumors lacked adjacent actinic keratosis (AK) and often had adjacent basaloid retiform proliferations. Most lesions (all but one) were well differentiated and about 40% could be classified histopathologically as keratoacanthoma. Perineural invasion was absent in all but one case. Using the American Joint Committee on Cancer (AJCC) staging criteria for SCC, 21 tumors were Stage I, and 9 Stage II. During 7-10 years of follow-up, no recurrence or metastasis occurred. Patients with multiple SCCs on the lower extremities can have a range of histopathologic features, from keratoacanthoma-like to well-differentiated SCC.
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Affiliation(s)
- William R Munday
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - David J Leffell
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Jennifer M McNiff
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA.,Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Christine J Ko
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA.,Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
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Ogita A, Ansai SI, Misago N, Anan T, Fukumoto T, Saeki H. Histopathological diagnosis of epithelial crateriform tumors: Keratoacanthoma and other epithelial crateriform tumors. J Dermatol 2016; 43:1321-1331. [DOI: 10.1111/1346-8138.13390] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/23/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Azusa Ogita
- Division of Dermatology; Nippon Medical School Musashi Kosugi Hospital; Kawasaki Japan
| | - Shin-ichi Ansai
- Division of Dermatology; Nippon Medical School Musashi Kosugi Hospital; Kawasaki Japan
| | | | - Takashi Anan
- Sapporo Dermatopathology Institute; Sapporo Japan
| | | | - Hidehisa Saeki
- Department of Dermatology; Nippon Medical School; Tokyo Japan
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10
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Gleich T, Chiticariu E, Huber M, Hohl D. Keratoacanthoma: a distinct entity? Exp Dermatol 2015; 25:85-91. [DOI: 10.1111/exd.12880] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2015] [Indexed: 01/20/2023]
Affiliation(s)
- Tobias Gleich
- Service of Dermatology; University Hospital Center and University of Lausanne; Lausanne Switzerland
| | - Elena Chiticariu
- Service of Dermatology; University Hospital Center and University of Lausanne; Lausanne Switzerland
| | - Marcel Huber
- Service of Dermatology; University Hospital Center and University of Lausanne; Lausanne Switzerland
| | - Daniel Hohl
- Service of Dermatology; University Hospital Center and University of Lausanne; Lausanne Switzerland
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Dillenburg CS, Martins MD, Meurer L, Castilho RM, Squarize CH. Keratoacanthoma of the Lip: Activation of the mTOR Pathway, Tumor Suppressor Proteins, and Tumor Senescence. Medicine (Baltimore) 2015; 94:e1552. [PMID: 26402814 PMCID: PMC4635754 DOI: 10.1097/md.0000000000001552] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The PI3K-PTEN-mTOR is one of the most important pathways involved in cancer development and progression; however, its role in keratoacanthoma (KA) is poorly understood. In this study, we investigated the activation of key proteins in the PI3K-mTOR pathway in lip KA. We analyzed the activation of the PI3K-PTEN-mTOR pathway using human tumor samples stained for well-established protein markers in this pathway, including pS6 and pAKT phosphoproteins. We assessed proliferation using Ki-67 and performed additional morphological and immunohistochemical analysis using anti-PTEN and anti-p16 antibodies.We found that the majority of KA labeled to pS6 and not pAKT. PTEN expression was inversely correlated with Ki-67 expression. In addition to PTEN expression, KA cells were positive for p16 senescence marker. PI3K-PTEN-mTOR pathway is activated in lip KA, leading to downstream activation of mTORC1, but not mTORC2. This pathway plays an important role in KA progression by promoting proliferation and activation of oncogenic-induced senescence.
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Affiliation(s)
- Caroline Siviero Dillenburg
- From the Department of Periodontics and Oral Medicine, Laboratory of Epithelial Biology, University of Michigan School of Dentistry, Ann Arbor, MI (CSD, MDM, RMC, CHS); Department of Oral Pathology, School of Dentistry (CSD, MDM); and Department of Pathology, Hospital de Clínicas de Porto Alegre and Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (LM)
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Aktinische Keratose, Morbus Bowen, Keratoakanthom und Plattenepithelkarzinom der Haut. DER PATHOLOGE 2015; 36:16-29. [DOI: 10.1007/s00292-014-2063-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Misago N, Takai T, Toda S, Narisawa Y. The changes in the expression levels of follicular markers in keratoacanthoma depend on the stage: keratoacanthoma is a follicular neoplasm exhibiting infundibular/isthmic differentiation without expression of CK15. J Cutan Pathol 2014; 41:437-46. [PMID: 24666173 DOI: 10.1111/cup.12317] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 11/19/2013] [Accepted: 12/28/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although the precise etiology of keratoacanthoma (KA) is unknown, KA is generally assumed to differentiate toward hair follicles based on previous studies of experimental carcinogenesis. METHODS We performed a comprehensive immunohistochemical study of various follicular markers in all stages of KA. A total of 67 tumors, including 16 early or proliferative stage lesions, 43 well-developed stage lesions, five regressing stage lesions and three regressed stage lesions, were subjected to the analysis. RESULTS CK15 (clone C8/144B), CK19 and CD34 were not expressed at any stage. CK1, CK10, CK16, CK17, CK15 (clone LHK15) and calretinin showed dynamic changes in their expression in KA depending on the stage. CONCLUSIONS KA is a follicular neoplasm with infundibular/isthmic (upper segmental region of hair follicles) differentiation. It is considered that early or proliferative stage tumors show keratin-filled invaginations with infundibular differentiation and gradual isthmic differentiation. Well-developed examples of KA generally show isthmic differentiation in the whole lesions. The regressed stage KAs lose the features of this type of follicular differentiation and show epidermal characteristics. No expression of CK15 (clone C8/144B) was observed in KAs, although this finding is insufficient to completely rule out the correlation between the regression of KA and the hair follicle cycle.
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Affiliation(s)
- Noriyuki Misago
- Division of Dermatology, Department of Internal Medicine, Saga University, Saga, Japan
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15
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Rompolas P, Greco V. Stem cell dynamics in the hair follicle niche. Semin Cell Dev Biol 2013; 25-26:34-42. [PMID: 24361866 DOI: 10.1016/j.semcdb.2013.12.005] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 11/27/2013] [Accepted: 12/11/2013] [Indexed: 12/17/2022]
Abstract
Hair follicles are appendages of the mammalian skin that have the ability to periodically and stereotypically regenerate in order to continuously produce new hair over our lifetime. The ability of the hair follicle to regenerate is due to the presence of stem cells that along with other cell populations and non-cellular components, including molecular signals and extracellular material, make up a niche microenvironment. Mounting evidence suggests that the niche is critical for regulating stem cell behavior and thus the process of regeneration. Here, we review the literature concerning past and current studies that have utilized mouse genetic models, combined with other approaches to dissect the molecular and cellular composition of the hair follicle niche. We also discuss our current understanding of how stem cells operate within the niche during the process of tissue regeneration and the factors that regulate their behavior.
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Affiliation(s)
- Panteleimon Rompolas
- Department of Genetics, Department of Dermatology, Yale Stem Cell Center, Yale Cancer Center, Yale School of Medicine, New Haven, CT 06510, USA.
| | - Valentina Greco
- Department of Genetics, Department of Dermatology, Yale Stem Cell Center, Yale Cancer Center, Yale School of Medicine, New Haven, CT 06510, USA.
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Aung PP, Ballester LY, Mahalingam M. Histopathology of Keratoacanthoma Revisited. Int J Surg Pathol 2013; 22:316-25. [DOI: 10.1177/1066896913509010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background/Aims. Given the defining histopathologic architecture of keratoacanthoma (KA), the aim of this study was to measure the crateriform orifice (“orificial size”) in histopathologically crateriform lesions to ascertain its utility as an objective diagnostic histopathologic adjunct. Methods. This cross-sectional, retrospective study included 97 cases with a histopathologic diagnosis of KA. We measured the “orificial size” using the ocular micrometer in a BH-2 Olympus microscope at 4× magnification, in a blinded manner with respect to information. Frequency of histopathologic features observed was also recorded. Results. The average orificial size for different groups was as follows: 2.3 ± 0.2 mm for cases with a clinical presentation of KA/keratotic papule (KP) (n = 30) versus 2.9 ± 0.3 mm for other (n = 67), P = .18. Histopathologic findings in the 2 groups were as follows: crateriform architecture/epithelial lip and sharp demarcation of tumor from stroma (100% in both groups), fibrosis (29/30 vs 64/67), apoptotic keratinocytes (27/30 vs 56/67), dermal islands of “glassy” keratinocytes (26/30 vs 54/67), entrapped elastic fibers (26/30 vs 49/67), and neutrophilic abscesses (11/30 vs 21/670 [ P = not significant for all]. Conclusion. Our findings indicate that, in the appropriate clinical setting, a smaller orificial size, although predictive of a KA, in itself is not sufficient for a definitive diagnosis. Given that a major limitation is that this is a function of age of the lesion as orificial size depends on the evolution stage of the neoplasm with the largest diameter often evident in lesions at early stages of regression, for now correlation with histopathologic features such as presence of an epithelial lip, sharp demarcation of tumor from stroma, and fibrosis (present in >95% of cases of KAs) is required.
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Affiliation(s)
- Phyu P. Aung
- Department of Pathology, National Institutes of Health, Baltimore, MD, USA
| | - Leomar Y. Ballester
- Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, MA, USA
| | - Meera Mahalingam
- Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, MA, USA
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A rapidly growing skin lesion. JAAPA 2013; 26:14. [PMID: 23610830 DOI: 10.1097/01720610-201304000-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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