Pseudocarcinomatous Hyperplasia With Follicular Differentiation Overlying Basal Cell Carcinoma

Etiology and Management of Peristomal Pseudoepitheliomatous Hyperplasia

This is a report of a 48-year-old male patient who presented with worsening peristomal dermatitis. He proceeded to form a nodular hyperplastic overgrowth that was proven to be pseudoepitheliomatous hyperplasia on histological examination. On surgical exploration, he was found to have an apparent peristomal enterocutaneous fistula propagating this hyperplastic growth. This report reviews the etiology and management of peristomal complications with special attention to pseudoepitheliomatous hyperplasia.

The Role Played by Growth Factors TGF-β1, EGF and FGF7 in the Pathogeny of Oral Pseudoepitheliomatous Hyperplasia

Pseudoepitheliomatous hyperplasia is an epithelial proliferation that develops in the dermis or lamina propria. It is a lesion associated to another pathology, which appears as a response to a great variety of infectious, neoplastic, inflammatory or traumatic stimuli. The etiopathogeny of this lesion is not clear yet. Therefore, we performed an immunohistochemical study on a group of 20 cases of pseudoepitheliomatous hyperplasia cases associated with inflammatory and neoplastic conditions, by investigating TGFβ1 (Beta growth and transformation factor), EGF (Epidermal growth Factor), and FGF7 (Fibroblast growth factor) expressions during in its development. The TGF-β1 expression was recorded in all the layers of the oral hyperplastic epithelium, going from the basal to the superficial layers, but with a different immunoreactive pattern, according to the region. Our study showed the absence of EGF immunoexpression in the carcinomatous proliferation areas associated to pseudoepitheliomatous hyperplasia and an almost exclusive presence in the hyperplasia lesions associated with inflammatory conditions (in about 30% of the investigated lesions) of a expression varying from poor to moderate for EGF. According to our investigations, we observed the presence of an immunolabeling for FGF7 in 80% of the investigated cases of pseudoepitheliomatous hyperplasia, a maximum of intensity being observed within the cases associated with inflammatory conditions.

Pseudoepitheliomatous hyperplasia: a review

Pseudoepitheliomatous hyperplasia (PEH) is a benign condition, characterized by hyperplasia of the epidermis and adnexal epithelium, closely simulating squamous cell carcinoma. PEH may be present in a number of conditions characterized by prolonged inflammation and/or chronic infection, as well as in association with many cutaneous neoplasms. Herein, we review different inflammatory, infectious, and neoplastic skin diseases, in which florid epidermal hyperplasia is a prominent histopathologic feature, and introduce a systematic approach in the interpretation of PEH.