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Olvera D, Hurley MY, Jeter M, Chow P, Hodges WT. Persistent Papules in Erythema Elevatum Diutinum Treated With Dapsone: Answer. Am J Dermatopathol 2024; 46:181-182. [PMID: 38354385 DOI: 10.1097/dad.0000000000002617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Affiliation(s)
- Diana Olvera
- New York Institute of Technology College of Osteopathic Medicine, Jonesboro, AR
| | - Maria Y Hurley
- Department of Dermatology, SSM Health/Saint Louis University School of Medicine, St. Louis, MO; and
| | | | - Peter Chow
- Department of Dermatology, SSM Health/Saint Louis University School of Medicine, St. Louis, MO; and
| | - Wesley T Hodges
- Department of Dermatology, SSM Health/Saint Louis University School of Medicine, St. Louis, MO; and
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2
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Mansour B, Donati M, Michalová K, Michal M, Ptáková N, Hájková V, Michal M. Epithelioid fibrous histiocytoma: three diagnostically challenging cases with novel ALK gene fusions, unusual storiform growth pattern, and a prominent spindled morphology. Virchows Arch 2022; 481:751-757. [PMID: 36171493 DOI: 10.1007/s00428-022-03418-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 10/14/2022]
Abstract
Epithelioid fibrous histiocytoma (EFH) is a distinctive cutaneous neoplasm with a relatively variable morphological appearance. Recently, it has been shown that this tumor is molecularly characterized by ALK gene fusions. We report three EFHs with unusual histological presentation represented by a prominent/predominant spindle cell proliferation arranged in a variably storiform/whirling architectural pattern with or without stromal sclerosis. One of the cases closely resembled cellular fibrous histiocytoma. All three cases were immunohistochemically ALK-positive and were analyzed for ALK gene rearrangements using a next-generation sequencing-based assay (FusionPlex Sarcoma Kit, ArcherDx). Three novel fusions, namely AP3D1::ALK, COL1A::ALK, and LRRFIP2::ALK, were detected and further confirmed by FISH in all 3 cases and RT-PCR in 1 case. All patients were elderly (62-63 years) and presented with a solitary polypoid lesion on the extremities. The awareness of these morphological variants is important since it entertains a wide and slightly different differential diagnosis than conventional EFH. We also presented evidence that a clear separation of EFH from BFH in all cases may not be as straightforward as previously thought. The consistent ALK immunoexpression and the continually expanding scale of ALK gene rearrangements provide a useful tool to distinguish EFH from its histologic mimics.
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Affiliation(s)
- Boulos Mansour
- Department of Pathology, University Hospital Campus Bio-Medico, Rome, Italy.
| | - Michele Donati
- Department of Pathology, University Hospital Campus Bio-Medico, Rome, Italy
| | - Květoslava Michalová
- Bioptical Laboratory, Ltd., Pilsen, Czech Republic.,Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Michal Michal
- Bioptical Laboratory, Ltd., Pilsen, Czech Republic.,Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | | | | | - Michael Michal
- Bioptical Laboratory, Ltd., Pilsen, Czech Republic.,Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
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3
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Frantz R, Chukwuma O, Sokumbi O, Satcher K, Kallis P, Vincek V, Motaparthi K. Identifying histopathologic features of erythema elevatum diutinum and granuloma faciale. J Cutan Pathol 2021; 49:323-326. [PMID: 34939211 DOI: 10.1111/cup.14191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Robert Frantz
- University of Florida College of Medicine, Gainesville, Florida, USA
| | - Olivia Chukwuma
- University of Florida College of Medicine, Gainesville, Florida, USA
| | - Olayemi Sokumbi
- Department of Dermatology, Mayo Clinic-Florida, Jacksonville, Florida, USA
| | - Kerrie Satcher
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Penelope Kallis
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Vladimir Vincek
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
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4
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Russell A, Johns A, Gross G, Rowe D. Multiple nodules on the bilateral aspect of the upper extremities. JAAD Case Rep 2021; 13:109-111. [PMID: 34189223 PMCID: PMC8219526 DOI: 10.1016/j.jdcr.2021.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Amanda Johns
- LewisGale Hospital Montgomery, Blacksburg, Virginia
| | - Gary Gross
- LewisGale Medical Center, Salem, Virginia
| | - David Rowe
- Patterson Rowe Wick Laboratory, Charlottesville, Virginia
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5
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García-Vázquez A, Guillen-Climent S, Rausell Félix F, Ramón Quiles M. Chronic Fibrosing Vasculitis: A Histologic Finding in a Case of Long-Established Erythema Elevatum Diutinum. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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6
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García-Vázquez A, Guillen-Climent S, Rausell Félix F, Ramón Quiles M. Vasculitis fibrosante crónica, manifestación histológica de un eritema elevatum diutinum de larga evolución. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.ad.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Vasculitis, characterized by inflammation and necrosis, manifests a wide spectrum of presentation by involving a vasculature of various sizes and locations. A definitive diagnosis of vasculitis invariably requires histologic confirmation since there are no diagnostic clinical, imaging, or laboratory findings. The most widely adopted vasculitis classification is the Chapel Hill Consensus Conference (CHCC) nomenclature of systemic vasculitis which integrated clinical symptoms, histopathologic features, and laboratory findings. This classification accounts for the size of the involved vessels. This chapter outlines the clinical and histologic features of the small-vessel vasculitis including the immune complex vasculitis and antineutrophil cytoplasmic antibody-associated vasculitis; medium-vessel vasculitis such as polyarteritis nodosa and Kawasaki disease; large-vessel vasculitis, namely, giant cell arteritis and Takayasu arteritis; variable-vessel vasculitis such as Behcet disease and Cogan syndrome; and vasculitis associated with systemic diseases including rheumatoid arthritis, lupus vasculitis, and sarcoid vasculitis. Vasculitis can also be secondary to drugs, infection, underlying systemic disease, or trauma. Therefore, a diagnosis of vasculitis cannot be based on histologic ground alone. Clinical pathologic correlation is necessary.
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Affiliation(s)
- Mai P. Hoang
- Professor of Pathology, Harvard Medical School, Director of Dermatopathology, Massachusetts General Hospital, Boston, MA USA
| | - Maria Angelica Selim
- Professor of Pathology and Dermatology, Director, Dermatopathology Unit, Duke University Medical Center, Durham, NC USA
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8
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Molinelli E, Paolinelli M, Campanati A, Brisigotti V, Offidani A. Metabolic, pharmacokinetic, and toxicological issues surrounding dapsone. Expert Opin Drug Metab Toxicol 2019; 15:367-379. [DOI: 10.1080/17425255.2019.1600670] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Matteo Paolinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Anna Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
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9
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Doktor V, Hadi A, Hadi A, Phelps R, Goodheart H. Erythema elevatum diutinum: a case report and review of literature. Int J Dermatol 2018; 58:408-415. [PMID: 30074624 DOI: 10.1111/ijd.14169] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 07/04/2018] [Accepted: 07/07/2018] [Indexed: 01/19/2023]
Abstract
Erythema elevatum diutinum (EED) is a rare cutaneous leukocytoclastic vasculitis thought to be related to increased levels of circulating antibodies. It has been shown to be associated with HIV infection, tuberculosis, as well as various autoimmune diseases. A retrospective review of all cases of EED indexed in PubMed between 1990 and 2014 was performed. Inclusion criteria for articles was availability of full text in English and a biopsy-confirmed diagnosis of EED. All other articles were excluded. Cases were stratified by age and anatomic location of the lesions. Treatment response was coded as "complete," "partial," and "none." A total of 133 cases of EED with 381 lesions detailed in case reports and case series were included. Twenty-one cases were associated with HIV. Of 47 patients with reported paraproteinemias, IgA paraproteinemia was found in 57.45%, IgG paraproteinemia in 29.8%, IgM paraproteinemia in 10.6%, and IgD paraproteinemia in 2.1% of cases. Of 40 (30.1%) patients with reported comorbid autoimmune disease, rheumatoid arthritis was associated with 10 cases. Cancer was found to be associated with 9.77% of cases. Seventy-five patients were treated with dapsone, with 36 (48%) achieving complete treatment response, 24 (32%) achieving partial response, and seven (9.3%) achieving no response. Keeping the clinical associations of EED in mind, especially malignancy, is critical in management of the disease. More structured studies need to take place in order to fully define the mechanisms and strength of these associations.
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Affiliation(s)
- Vladyslava Doktor
- Dermatology Department, St. John's Episcopal Hospital, Far Rockaway, NY, USA
| | - Ahmed Hadi
- The Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ali Hadi
- The Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert Phelps
- The Kimberly and Eric J. Waldman Department of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Herbert Goodheart
- The Kimberly and Eric J. Waldman Department of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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10
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Singer SB, Thomas C, Lezcano C, Robbins M, Gordian A, Nori S, Granter SR, Merola JF, O'Malley JT. Polyarthralgias and Papulonodules in a 56-Year-Old Woman. Arthritis Care Res (Hoboken) 2018; 70:925-930. [PMID: 29342504 DOI: 10.1002/acr.23516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/09/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Sean B Singer
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cristina Thomas
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cecilia Lezcano
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mark Robbins
- Harvard Vanguard Medical Associates/Atrius Health, Boston, Massachusetts
| | - Amparo Gordian
- Harvard Vanguard Medical Associates/Atrius Health, Boston, Massachusetts
| | - Sarita Nori
- Harvard Vanguard Medical Associates/Atrius Health, Boston, Massachusetts
| | - Scott R Granter
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joseph F Merola
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - John T O'Malley
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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11
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Shi KY, Vandergriff T. Late-stage nodular erythema elevatum diutinum mimicking sclerotic fibroma. J Cutan Pathol 2017; 45:94-96. [PMID: 29068068 DOI: 10.1111/cup.13066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/22/2017] [Accepted: 10/19/2017] [Indexed: 11/27/2022]
Abstract
Erythema elevatum diutinum (EED) is a rare, cutaneous vasculitis of uncertain origin. EED can present clinically as chronic bilateral, symmetrical, periarticular papules, plaques and nodules. We report here an unusual case of EED presenting as multiple, densely fibrosing nodules on the feet of a 60-year-old human immunodeficiency virus positive woman. The initial evaluation of the patient was complicated by the strong histologic resemblance of multiple lesions to sclerotic fibroma, a cutaneous manifestation of Cowden disease. Our case highlights the important features that distinguish these 2 pathologic entities.
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Affiliation(s)
- Kevin Y Shi
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Travis Vandergriff
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
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13
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Rao GR, Joshi R, Phaneendra Prasad AK, Amareswar A, Sandhya S, Sridevi M. Nodular Erythema Elevatum Diutinum Mimicking Kaposi's Sarcoma in a Human Immunodeficiency Virus Infected Patient. Indian J Dermatol 2014; 59:592-4. [PMID: 25484391 PMCID: PMC4248498 DOI: 10.4103/0019-5154.143527] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Erythema elevatum diutinum (EED) has been emerging as a specific Human Immunodeficiency Virus (HIV) associated dermatosis in recent times. It is an extremely rare chronic disease of unknown origin and part of the spectrum of leukocytoclastic vasculitis. We describe a case of EED simulating Kaposi's sarcoma in a 52-year-old HIV infected female patient with no previous opportunistic infections and CD4+ count of 164/mm(3). Therapy with oral dapsone (100 mg/day) for two weeks resulted in resolution of some lesions.
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Affiliation(s)
- G Raghurama Rao
- Department of DVL, GSL Medical College, Rajahmundry, Andhra Pradesh, India
| | - Rajiv Joshi
- Department of Dermatopathology, Hinduja Hospitals, Mumbai, Maharashtra, India
| | | | - A Amareswar
- Surya Skin Care and Research Center, Visakhapatnam, Andhra Pradesh, India
| | - S Sandhya
- Surya Skin Care and Research Center, Visakhapatnam, Andhra Pradesh, India
| | - M Sridevi
- Surya Skin Care and Research Center, Visakhapatnam, Andhra Pradesh, India
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14
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Momen S, Jorizzo J, Al-Niaimi F. Erythema elevatum diutinum: a review of presentation and treatment. J Eur Acad Dermatol Venereol 2014; 28:1594-602. [DOI: 10.1111/jdv.12566] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 04/29/2014] [Indexed: 01/19/2023]
Affiliation(s)
- S.E. Momen
- St John's Institute of Dermatology; London UK
| | - J. Jorizzo
- Wake Forest Baptist Health; Winstom Salem North Carolina USA
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15
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Val-Bernal JF, González-Vela MC, De Grado M, Garijo MF. Sclerotic fibroma (storiform collagenoma)-like stroma in a fibroadenoma of axillary accessory breast tissue. J Cutan Pathol 2012; 39:798-802. [DOI: 10.1111/j.1600-0560.2012.01940.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2012] [Indexed: 11/28/2022]
Affiliation(s)
- José Fernando Val-Bernal
- Anatomical Pathology Department, Marqués de Valdecilla, University Hospital, Medical Faculty; University of Cantabria and IFIMAV; Santander; Spain
| | - María Carmen González-Vela
- Anatomical Pathology Department, Marqués de Valdecilla, University Hospital, Medical Faculty; University of Cantabria and IFIMAV; Santander; Spain
| | - Mauricio De Grado
- Ambulatory Surgical Unit, Marqués de Valdecilla; University Hospital; Santander; Spain
| | - María Francisca Garijo
- Anatomical Pathology Department, Marqués de Valdecilla, University Hospital, Medical Faculty; University of Cantabria and IFIMAV; Santander; Spain
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16
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Lekhanont K, Patarakittam T, Mantachote K, Waiyawatjamai P, Vongthongsri A. Progressive Keratolysis with Pseudopterygium Associated with Erythema Elevatum Diutinum. Ophthalmology 2011; 118:927-33. [DOI: 10.1016/j.ophtha.2010.09.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 08/11/2010] [Accepted: 09/14/2010] [Indexed: 11/30/2022] Open
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17
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Chan Y, Mok CC, Tang WYM. Erythema elevatum diutinum in systemic lupus erythematosus. Rheumatol Int 2010; 31:259-62. [PMID: 20652813 DOI: 10.1007/s00296-010-1574-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2010] [Accepted: 07/11/2010] [Indexed: 11/24/2022]
Abstract
Erythema elevatum diutinum (EED) is a rare chronic form of leukocytoclastic vasculitis with unknown etiology. EED has been described in association with hematological malignancies, infections and a number of rheumatological diseases. We report a patient with systemic lupus erythematosus (SLE) who presented with intermittent attacks of tender nodules and plaques on the shins and ankles for 6 months. Skin biopsy confirmed the diagnosis of EED. Treatment with dapsone resulted in complete resolution of the skin lesions. EED is rarely reported in SLE, and its presentation and treatment is reviewed.
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Affiliation(s)
- Yung Chan
- Department of Medicine, Tuen Mun Hospital, New Territories, Hong Kong
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18
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Costa FB, Duquia RP, Souza PRM, Vettorato G, Almeida HLD. [Case for diagnosis. Erythema elevatum diutinum]. An Bras Dermatol 2009; 84:429-30. [PMID: 19851679 DOI: 10.1590/s0365-05962009000400018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Erythema elevatum diutinum is a rare presentation of cutaneous vasculitis. Typical lesions are papules, plaques, and nodules that may coalesce and later turn to yellow-brown color. The extensor surface of the extremities is the most involved area and older lesions may present xanthomatous appearance. Light microscopy of acute lesions shows neutrophilic, perivascular infiltrate with dermal fibrin deposits, endothelial expansion, and leukocytoclasis. We present a case of erythema elevatum diutinum without associated disease.
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Soubeiran E, Wacker J, Haußer I, Hartschuh W. Erythema elevatum diutinum with unusual clinical appearance. J Dtsch Dermatol Ges 2008; 6:303-5. [DOI: 10.1111/j.1610-0387.2008.06589.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Braun-Falco M, Hofmann H. An HIV-Positive Man with Slowly Enlarging Nodules on the Extremities. Clin Infect Dis 2007. [DOI: 10.1086/512373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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21
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Goo B, Cho SB, Cho YH, Lee EH, Bang D, Kim YC, Vandersteen DP. Fibrolamellar nerve sheath tumor or sclerotic neurofibroma? J Cutan Pathol 2006; 33:760-1. [PMID: 17083698 DOI: 10.1111/j.1600-0560.2006.00521.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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High WA, Stewart D, Essary LR, Kageyama NP, Hoang MP, Cockerell CJ. Sclerotic fibroma-like change in various neoplastic and inflammatory skin lesions: is sclerotic fibroma a distinct entity? J Cutan Pathol 2004; 31:373-8. [PMID: 15059222 DOI: 10.1111/j.0303-6987.2004.00199.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Sclerotic fibroma was first described in association with Cowden's disease by Weary et al. in 1972. In 1989, Rapini and Golitz detailed 11 cases of solitary sclerotic fibroma (SFS) in the absence of Cowden's disease, suggesting the term SFS of the skin. Classic histological features include hypocellular, hyalinized bands of collagen sharply demarcated from the surrounding skin. Numerous authors have described sclerotic fibroma-like changes in other entities including melanocytic nevi, dermatofibromas, lipomas, tendon sheath fibromas, giant cell collagenomas, neurofibromas, angiofibromas, erythema elevatum diutinum, and folliculitis. Dissension has arisen, with some dermatopathologists asserting that sclerotic fibroma is just an evolutionary end-point of a previous lesion. Others contend that SFS is a distinct lesion and cite recurrent cases and/or proliferation marker studies to corroborate this view. We detail the histopathological findings of lesions consistent with the classic description of SFS and compare these to sclerotic changes observed in an intradermal nevus, blue nevus, erythema elevatum diutinum, neurofollicular hamartoma, angiofibroma, neurofibroma, accessory nipple, and dermatofibromas. Sclerotic fibroma-like change may be seen in a variety of lesions and may represent a common reaction pattern in the skin.
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Affiliation(s)
- Whitney A High
- Department of Dermatology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, F4.100, Dallas, TX 75390-9069, USA.
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